Medicine and Health Sciences Commons^™

Antimicrobial Resistance And Rational Prescription Practices: Knowledge, Perceptions And Confidence Of Health Profession Interns In Uganda, Shamim Nabidda, Rogers Ssennyonjo, Joseph Atwaru, Andrew Marvin Kanyike, Shiellah Baryayaka, Kennedy Pangholi, Jonans Tusiimire

School of Nursing & Midwifery, East Africa

Background

Antimicrobial resistance (AMR) is significantly driven by misuse and overuse of antibiotics. Graduate health profession interns often prescribe antimicrobials under minimum supervision.

Objectives

This study explored the knowledge, perceptions and confidence of health profession interns in Uganda regarding AMR and rational prescription practices.

Methods

This was a cross-sectional survey employing quantitative techniques carried out between October and November 2022 at six tertiary hospitals in Uganda. Health profession interns including doctors, nurses, midwives and pharmacists were recruited as study participants. Data were collected using online Kobo toolbox software. Data analysis was performed using STATA (StataCorp) version 16. Bivariate analysis and …

Work-Related Stress Among Midwives In Central Uganda. A Key Comparison Between Rural-Urban And Private-Public Midwives: A Cross-Sectional Study, Diana Mbatudde, Ahmed Sarki, Ofra Halperin, Ekaete Asuquo, Grace Edward

Journal of Asian Midwives (JAM)

Background: Midwives in Uganda face challenges that predispose them to vulnerability and traumatic work-related stress which may impact the provision of quality midwifery care and the well-being of midwives. This study aimed at exploring the prevalence and sources of work-related stress and comparing the differences in the experiences of stress among rural or urban midwives and private or public midwives in health facilities in central Uganda.
Methods: A descriptive cross-sectional study design was utilized. The 57-item Expanded Nursing Stress Scale (ENSS) was used to collect data from 208 midwives working in urban and rural (both public and private) health facilities …

The Meaning Of Caring For Patients With Cancer Among Traditional Medicine Practitioners In Uganda: A Grounded Theory Approach, John Baptist Asiimwe, Prakash B. Nagendrappa, Esther C. Atukunda, Grace Nambozi, Casim U. Tolo, Martin Ogwang, Mauda M. Kamatenesi

School of Nursing & Midwifery, East Africa

Traditional medicine practitioners (TMPs) are a critical part of healthcare systems in many sub-Saharan African countries and play vital roles in caring for patients with cancer. Despite some progress in describing TMPs’ caring experiences in abstract terms, literature about practice models in Africa remains limited. This study aimed to develop a substantive theory to clarify the care provided by TMPs to patients with cancer in Uganda. This study adhered to the principal features of the modified Straussian grounded theory design. Participants were 18 TMPs caring for patients with cancer from 10 districts in Uganda, selected by purposive and theoretical sampling …

Factors Influencing The Use Of Multiple Hiv Prevention Services Among Transport Workers In A City In Southwestern Uganda, Benjamin Betunga, Phionah Atuhaire, Catherine Nakasiita, Christa Kanyamuneza, Proscovia Namiiro, Joseph Tugume, Matovu Hairat, Ahmed Sarki, Benedicto Mugabi, Birungi Lilian, Richard Mugisha Richard Mugisha, Edward Kumakech, John Baptist Asiimwe

School of Nursing & Midwifery, East Africa

The use of multiple HIV prevention services has been found to decrease the risk of acquiring HIV when tailored to individuals at risk of HIV exposure, including transport workers. Therefore, we assessed the uptake of multiple HIV prevention services (≥2) and associated factors among transport workers in a city in Southwestern Uganda. This cross-sectional study comprised motorcycle taxi riders, motor vehicle and truck drivers, aged 18 to 55 years who were selected and responded to an interviewer-administered questionnaire, between November 2021 and February 2022. Data was analyzed using descriptive statistical and modified Poisson regression analyses. Out of 420 participants, 97.6% …

Implementation Of Evidence-Based Multiple Focus Integrated Intensified Tb Screening To End Tb (Exit-Tb) Package In East Africa: A Qualitative Study, Kahabi Isangula, Doreen Philbert, Florence Ngari, Tigest Ajeme, Godfather Kimaro, Getnet Yimer, Nicholaus P. Mnyambwa, Winters Muttamba, Irene Najjingo, Aman Wilfred

School of Nursing & Midwifery, East Africa

Introduction Tuberculosis (TB) remains a major cause of morbidity and mortality, especially in sub-Saharan Africa. We qualitatively evaluated the implementation of an Evidence-Based Multiple Focus Integrated Intensified TB Screening package (EXIT-TB) in the East African region, aimed at increasing TB case detection and number of patients receiving care.

Objective We present the accounts of participants from Tanzania, Kenya, Uganda, and Ethiopia regarding the implementation of EXIT-TB, and suggestions for scaling up.

Methods A qualitative descriptive design was used to gather insights from purposefully selected healthcare workers, community health workers, and other stakeholders. A total of 27, 13, 14, and 19 …

Experiences Of Mothers And Significant Others In Accessing Comprehensive Healthcare In The First 1000 Days Of Life Post-Conception During Covid-19 In Rural Uganda, Grace Nakate, Sean Mackay, Eunice Ndirangu, Valerie Fleming

School of Nursing & Midwifery, East Africa

Background: COVID-19 presented an unprecedented global public health challenge because of its rapid and relentless spread, and many countries instituted lockdowns to prevent the spread of infection. Although this strategy mayhave been appropriate to reduce infection, it presented unintended difficulties in rural Uganda, especially in maternal and born newborn care. For example, some services were suspended, meaning the nearest health facility was at a considerable distance. This study explored the experiences of mothers and their significant others of comprehensive care in the first 1000 days of life post-conception during the COVID-19 pandemic in Bunghokho-Mutoto sub-county, Mbale District, Uganda.

Methods …

Health Workers’ Documentation Process As A Prerequisite To The Integration Of Patient Care At A Regional Referral Hospital In Uganda, Grace Nakate, Mary Moleki, Ahmed Sarki, Valerie Fleming

School of Nursing & Midwifery, East Africa

Background: Integrated patient care is necessary for better care outcomes. Documentation enhances the integration of care; however, in the Ugandan setting, documentation of care is poor (e.g., omissions and incomplete records) and integration of patient care is not visible. This study presents a review of patient health records that was undertaken to understand documentation of care at a regional referral hospital in Eastern Uganda. This information will help in developing a documentation model to facilitate the integration of patient care in Uganda.

Methodology: This retrospective review involved 513 patient health records from the medical-surgical, pediatric, and obstetric/gynecological departments of Jinja …

Unit Knowledge And Practice Of Emergency Nursing Interventions At A Tertiary Public Cardiac Health Center In Uganda, Harriet Namukwaya, Cliff Asher Aliga, Grace Nakate, Judith Mutyabule

School of Nursing & Midwifery, East Africa

Background: Research suggests that many of the millions of deaths and long-term disabilities resulting from acute cardiovascular events and other emergency conditions are preventable if effective emergency care services were readily available. Effective emergency care requires trained and competent staff, including registered nurses. Most educational pathways do not adequately prepare nurses to deliver sensitive health care services for those with acute illness and injury. This includes Uganda, where few capacity-building initiatives have targeted emergency nursing care delivery, leading to knowledge and practice gaps.

Purpose: This study aimed to assess emergency nursing knowledge and clinical practice at a tertiary …

Intimate Partner Violence Disclosure And Associated Factors Among Pregnant Women Attending A City Hospital In South-Western Uganda: A Cross-Sectional Study, Eve Katushabe, John Baptist Asiimwe, Vincent Batwala

School of Nursing & Midwifery, East Africa

Background: Intimate partner violence (IPV) during pregnancy is a public health problem in Uganda that negatively impacts maternal and newborn health outcomes. However, IPVdisclosure and associated factors among pregnant women have remained poorly documented in southwestern Uganda. Therefore, this study determined IPV disclosure and associated factors among pregnant women attending a large City hospital.

Methods: In a cross-sectional design, 283 women attending Mbarara City Hospital Antenatal care (ANC) clinic were consecutively recruited into the study. Data was collected using a semi-structured questionnaire. This was administered by the research team and the exercise took over a month. That is; from 7th …

Perinatal Care In Western Uganda: Prevalence And Factors Associated With Appropriate Care Among Women Attending Three District Hospitals, Mercy Muwema, Dan K. Kaye, Grace Edwards, Gorrette Nalwadda, Joanita Nangendo, Jaffer Okiring, Wilson Mwanja, Elizabeth N. Ekong, Joan N. Kalyango, Joaniter I. Nankabirwa

School of Nursing & Midwifery, East Africa

Background: Perinatal mortality remains high globally and remains an important indicator of the quality of a health care system. To reduce this mortality, it is important to provide the recommended care during the perinatal period. We assessed the prevalence and factors associated with appropriate perinatal care (antenatal, intrapartum, and postpartum) in Bunyoro region, Uganda. Results from this study provide valuable information on the perinatal care services and highlight areas of improvement for better perinatal outcomes.

Methods: A cross sectional survey was conducted among postpartum mothers attending care at three district hospitals in Bunyoro. Following consent, a questionnaire was …

Prevalence And Determinants Of Intimate-Partner Violence Among Pregnant Women Attending A City Health Centre Iv, South Western Uganda, During The Covid-19 Pandemic: A Cross-Sectional Study, Eve Katushabe, Anthonia Chinweuba, Altraide Omieibi, John Baptist Asiimwe

School of Nursing & Midwifery, East Africa

Background:

Intimate Partner Violence (IPV) during pregnancy is a significant public health problem worldwide and its impact on newborn outcomes is largely documented. Although conditions resulting from the COVID-19 pandemic have provided a perfect environment for IPV to thrive, the magnitude of IPV among pregnant women remains unclear. This study aimed to determine the prevalence and determinants of IPV during the COVID-19 pandemic among pregnant women in south-western Uganda.

Methodology:

This cross-sectional study of 345 pregnant women attending a large City Health Care facility consecutively enrolled. The validated WHO semi-structured women’s health and domestic violence questionnaire was used to identify …

Use Of Face Masks To Limit The Spread Of The Covid-19 Among Western Ugandans: Knowledge, Attitude And Practices, Franck Katembo Sikakulya, Robinson Ssebuufu, Simon Binezero Mambo, Theophilus Pius, Annet Kabanyoro, Elizabeth Kamahoro, Yusuf Mulumba, Jean Kakule Muhongya, Patrick Kyamanywa

School of Nursing & Midwifery, East Africa

Background

The world is grappling with an ever-changing COVID-19 pandemic using preventive measures such as personal hygiene, face masks, restrictions on travel and gatherings in communities, in addition to a race to find a vaccine. The purpose of this study was to evaluate the knowledge, attitudes and practices of the western Uganda community on the proper use of face masks to mitigate the spread of COVID-19.

Methods A cross-sectional study using a structured questionnaire was carried out from 1^st July to 10^th July 2020 among western Ugandans of the consent age of 18 years and above. Data was …

Measuring Service Quality And Assessing Its Relationship To Contraceptive Discontinuation: A Prospective Cohort Study In Pakistan And Uganda, Karen T. Chang, Nirali M. Chakraborty, Amanda M. Kalamar, Waqas Hameed, Ben Bellows, Karen A. Grépin, Agha Xaher Gul, Sarah E K. Bradley, Lynn M. Atuyambe, Dominic Montagu

Community Health Sciences

Background: The quality of contraceptive counseling that women receive from their provider can influence their future contraceptive continuation. We examined (1) whether the quality of contraceptive service provision could be measured in a consistent way by using existing tools from 2 large-scale social franchises, and (2) whether facility quality measures based on these tools were consistently associated with contraceptive discontinuation.
Methods: We linked existing, routinely collected facility audit data from social franchise clinics in Pakistan and Uganda with client data. Clients were women aged 15-49 who initiated a modern, reversible contraceptive method from a sampled clinic. Consented participants completed an …

Evaluating A Work/Study Programme For Nurses And Midwives At Aga Khan University, Uganda, Hellen Kyakuwaire, Agnes Kirikumwino, Juliet Nabossa, Grace Edwards

School of Nursing & Midwifery, East Africa

The work/study programme for nurses and midwives at Aga Khan University School of Nursing and Midwifery (AKU-SONAM) is a unique concept in East Africa. This study explored whether nursing and midwifery students undergoing a work-study programme at AKU-SONAM felt their education was underpinned by an adult education philosophy. A semi-structured questionnaire designed specifically for this study based on the Knowles’ (1980) ‘Principles of Adult Education’ was administered to 96 students who completed their programmes in 2017 and 2018 respectively. Our paper reports on both the positive aspects of students’ experiences in this work-study programme, including the improvement of critical thinking …

Cultural Assessment: A Study Of Midwives’ Knowledge, Attitude And Self-Reported Practice In Uganda, Mercy Muwema, Karen Drake, Pamela Friesen, Grace Edwards

Journal of Asian Midwives (JAM)

Background: Cultural assessment is critical due to the increased movement and resettlement of people across the globe, and diverse cultural groups in Uganda. This is putting the health care delivery systems serving the communities under pressure to recognize the different attitudes of people towards health and to develop care systems that are effective in meeting diverse needs. However, despite the importance of cultural assessment in nursing literature, little is known about the cultural assessment competence of Ugandan midwives. This study assessed the knowledge, attitude, and practice of midwives in this assessment process.

Methods: A descriptive correlational design was used to …

Examining Nursing Practices For Management Of Sepsis In Low Income Countries: The Case Of Uganda, Cliff Aliga, Judith Mutyabule, Grace Nakate, Abigail Emelonye

School of Nursing & Midwifery, East Africa

Examining nursing practice guidelines to improve quality of care for patients with sepsis in low income countries is required.

A large amount of information about best practice standards in sepsis management is available for healthcare professionals; however, implementation and adherence to practice guidelines recommended by the Surviving Sepsis Campaign remains low in low income countries.

A formal scope of practice for nursing and midwifery as a professional guideline is absent and national clinical guideline for Uganda remains unclear regarding the specific management of sepsis.

Inadequate documentation of patient care in Uganda makes sepsis cases difficult to be early detected.

Research …

Challenges Of Mass Media Interventions Regarding Mental Health: A Community Exemplar In Kampala Uganda, Moses Wankiiri, P. Petrucka

School of Nursing & Midwifery, East Africa

The Community Psychiatric Support Organization is a registered voluntary not for profit NGO in Uganda working to promote mental health by empowering the community to care for the mentally ill. Mental illness occurring in Uganda is often ‘explored’ or ‘explained’ from non-medical perspectives, including social, cultural, and/or religious belief systems. Over the last two years, the organization has conducted sixty six (66) live radio mental health education talks and twenty six (26) live television talk shows in an effort to reduce stigma towards mental illness. Such campaigns within developing contexts have not be examined extensively, although, in other sectors such …

Introducing A New Cadre Into Uganda’S Health Care System: Lessons Learnt From The Implementation Process, Gerald M. Amandu, Leana R. Uys, Joseph Mwizerwa, Alex Erejo, Irene A. Cheruto, Margaret Chota

School of Nursing & Midwifery, East Africa

Uganda introduced Registered Comprehensive Nursing (RCN) and Enrolled Comprehensive Nursing (ECN) training programs in 1994 and 2003 respectively, to create certificate and diploma level cadre of nurses with competencies in general nursing, midwifery, public health, psychiatry, paediatrics and management. This paper is based on an evaluation study undertaken to assess how the programs were implemented including stakeholders’ perceptions about the graduates. Despite being relevant, the implementation process of both programs failed to meet acceptable standards. We conclude that introducing a new cadre of nurses without proper preparation hinders realization of their full potential including their contribution to the healthcare system.