FoHSM http://dissertations.umu.ac.ug/xmlui/handle/123456789/14 2026-05-21T21:21:53Z 2026-05-21T21:21:53Z Ssemwanga, Steven Loudel http://dissertations.umu.ac.ug/xmlui/handle/123456789/1860 2026-05-07T12:46:34Z 2025-07-01T00:00:00Z

Factors associated with neonatal outcome of referred neonates from lower-level health facilities to Jinja Regional Referral Hospital Ssemwanga, Steven Loudel Background: Neonatal mortality is a key public health concern. The neonatal mortality rate currently stands at approximately 18 deaths per 1,000 live births, translating into millions of deaths annually. Almost half of all neonatal deaths occur in the first day of life, largely from preventable causes such as infection, asphyxia, and complications of prematurity. Despite efforts to improve neonatal care, outcomes remain suboptimal, particularly for neonates referred from lower-level facilities to regional hospitals. Late referrals, inadequate pre-referral stabilization, and resource constraints contribute to high mortality rates Objectives: This study aimed to determine the factors associated with neonatal outcomes among referred neonates at Jinja Regional Referral Hospital. Methods: A retrospective longitudinal study design employing documentary review of referred neonates at Jinja Regional Referral Hospital. A structured data extraction tool was used to collect data from neonatal records of all the referred neonates admitted to JRRH’s Neonatal Unit were reviewed between December 2024 and December 2023. The collected data were coded, entered into Excel spreadsheet, and analyzed using STATA 14. Data was presented in form of text, tables and graphs. Ethical approval and permission to access records obtained from JRRH management was obtained. Logistic regression was used to test for association while an prevalence ratio was as the measure of the association between the two variables and data was presented in term so text, table and pie-charts. Results: A total of 87 referred neonates admitted to JRRH’s Neonatal Unit were reviewed between December 2024 and December 2023 community members. From the study, the survival of referred neonates admitted to JRRH’s Neonatal Unit was at 63.2%. The most common primary reason for referral was prematurity, accounting for 35.6% of cases. Survival of the referred neonates admitted to JRRH’s Neonatal Unit was significantly associated with being referred from health facilities located within 10 km ((APR: 1.380; 95% CI: 1.076-1.584; p = 0.029), staying in the hospital for three days or less (APR: 1.240; 95% CI: 1.083–1.837; p = 0.024) and having not develop complications during hospitalization (APR: 1.202; 95% CI: 1.064-1.927; p = 0.034). Conclusion: The study found that survival was low. Therefore, it is recommended that the Ministry of Health should enhance neonatal referral systems, especially for facilities located more than 10 km from the referral hospital and prioritize equipping lower-level health facilities with basic neonatal care infrastructure and skilled personnel Lwenge Mathias

2025-07-01T00:00:00Z Tumwesigye, Philip http://dissertations.umu.ac.ug/xmlui/handle/123456789/1859 2026-05-07T12:46:36Z 2025-05-01T00:00:00Z

Factors influencing the uptake of tuberculosis preventive therapy (TPT) among female (18-49 years) household contacts of bacteriologically confirmed TB patients in Wakiso District, Uganda. Tumwesigye, Philip Introduction: Tuberculosis (TB) remains a leading cause of morbidity and mortality in Uganda, with household contacts of bacteriologically confirmed TB patients facing heightened risk of infection. Although Tuberculosis Preventive Therapy (TPT) is an effective intervention, its uptake among adult female contacts remains suboptimal. In particular, women of reproductive age face intersecting vulnerabilities that may influence their decision to initiate TPT. This study investigates individual, community, and health system factors influencing TPT uptake in Wakiso District, Uganda. Objective: To assess the factors influencing the uptake of TPT among female household contacts aged 18–49 years of bacteriologically confirmed TB patients in Wakiso District. Methodology: A mixed-methods cross-sectional study design was employed. Quantitative data were collected through structured interviews with 317 eligible women using a multistage sampling approach. Logistic regression analyses were used to identify associations between independent variables and TPT uptake. Qualitative data were gathered through four in-depth interviews with TB contacts purposively selected by health workers and community health personnel and analyzed thematically to contextualize the quantitative findings per objective. Results: TPT uptake among respondents was 76%. Key individual-level predictors of higher uptake included having primary or secondary education (AOR = 4.76; p = 0.018) and informal employment (AOR = 2.40; p = 0.025). At the community level, participants exposed to health talks or community health worker visits were more likely to initiate TPT, while stigma and fear of being mistaken for an active TB case remained deterrents. Among health system factors, women who experienced long wait times at health facilities (AOR = 2.26; p = 0.003) or medicine stockouts (AOR = 2.53; p = 0.022) paradoxically showed higher TPT initiation, suggesting persistence despite service inefficiencies. Qualitative insights highlighted the importance of supportive health worker interactions, privacy assurance, concern about side effects, and accessibility, with logistical barriers, such as transportation and stockouts, frequently cited. Conclusion: Despite relatively high TPT uptake, gaps remain due to educational, perceptual, and systemic barriers. Interventions to improve TPT coverage should focus on providing tailored health education, reducing stigma, and strengthening community-based delivery systems. Ensuring consistent medicine availability and enhancing provider-client relationships can significantly improve adherence and retention in TPT programs among women in high TB burden settings. Miisa Nanyingi

2025-05-01T00:00:00Z Acheng, Mystica Jameto http://dissertations.umu.ac.ug/xmlui/handle/123456789/1725 2026-03-10T07:09:12Z 2017-01-01T00:00:00Z

Examining the practice of school based sexuality education programme in primary schools in Bugiri district Acheng, Mystica Jameto Sexuality education has been highly controversial in Uganda in the past several decades. This comes as a result of perceived resistances from parents, teachers, religious leaders and law makers which are due to misunderstandings about the nature, purpose, and effects of sexuality education on young people (Boonstra, 2011; UNESCO, 2009). This study intended to examine the practice of school based sexuality education in primary schools in Bugiri district. It specifically examined the type of sexuality education program available to pupils, determined the factors influencing the type of sexuality education delivered, and critically assessed the usefulness of existing sexuality education programmes in Bugiri district. The study was a cross sectional study design which was descriptive in nature. Both quantitative and qualitative techniques for data collection which include questionnaires, focus group discussion, interviews and documentary review were used to collect data. Purposive sampling was utilized to select teachers and key informants according to their knowledge about the topic being researched while pupils were selected randomly. The data collected was analyzed using SPSS 16.0 for quantitative data while thematic analysis was used for qualitative data. The study found that the most commonly employed type of sexuality education was comprehensive education. Also, most of the teachers (72.2%) had integrated sexuality education lessons in other subjects and some teachers (26.5%) taught the lessons during co-curricular activities. While some teachers were not decided on a systematic way of teaching the subject. This means that there is no clear guidance at school level on how this type of education should be delivered thus, teachers did what was easier to practice. From the study findings time allocated to teach sexuality education was not adequate. The teachers indicated that most parents had positive attitude towards sexuality education. This is contributed to by the whole school approach used. The findings further indicated that the current practice of sexuality education in primary schools is poor (77.5%).This is due to the fact that sexuality education is not examinable hence teachers gave the subject less attention. Sexuality education was not part of teacher training curriculum, and there were no adequate facilities to facilitate teaching. Comprehensive education formed the most common type of sexuality education delivered to pupils in primary schools. Although it was also found that not all the teachers were teaching all topics in the curriculum, some skipped other topics. This means that some pupils did not receive holistic information to influence behavior positive change. Lack of adequate knowledge on sexuality education among teachers, limited resources and minimal time allocated for teaching sexuality education and believes influenced implementation of sexuality education curriculum in primary schools. Despite the critical importance and evidence justifying the need for sexuality education, the actual delivery of sexuality education in primary schools is still insufficient to help young people develop personal skills and influence behaviour change. Government should harmonize sexuality education curriculum for primary schools. All primary schools should be involved in sexuality education to facilitate reach of adolescents at risk due to limited and sometimes inaccurate information regarding sexuality issues. The training of teachers on sexuality education should be integrated as part of the teacher training curriculum and government should introduce an in-service course for teachers on sexuality education. The districts should develop clear tools for monitoring implementation of school based sexuality education to ensure quality age appropriate information are provided to all pupils. The issue of misconception around sexuality education topics should be taken up as serious advocacy issues that require attention of all stakeholders. Lillian Nantume Wampande

2017-01-01T00:00:00Z Nsubuga, Fredrick http://dissertations.umu.ac.ug/xmlui/handle/123456789/1693 2025-05-29T02:25:09Z 2020-03-01T00:00:00Z

Factors associated with untimely uptake of early infant diagnosis (EID) testing among HIV exposed infants (HEI) Nsubuga, Fredrick Background: Highly Exposed Infants (HEI) to HIV through their HIV positive mothers, require to receive timely Early Infant Diagnosis (EID) to enable identification of HIV positive infants, as to facilitate early treatment and follow up, and for negative infants, to reduce risk of infection by planning, counselling on appropriate feeding whilst maintaining adequate nutrition. Objective: To assess the factors associated untimely uptake of Early Infant Diagnosis (EID) among HEIs attending Kiryandongo General Hospital. Methodology: A cross-sectional study design was undertaken among 112 mothers in Kiryandongo Hospital, Kiryandongo District. All HIV positive mothers with HEIs aged 4 weeks to 18 months, enrolled and active in the Mother Baby Care Point (MBCP) in Kiryandongo Hospital were included in this study. Logistic regression was used to assess the factors associated with untimely EID among HEIs’. The data was analyzed by STATA 12 statistical software. Results: Most (70%) of HEIs obtained untimely EID. With all variables accounted for, the statistically independent predictor of untimely EID among HEIs where families where the household head had primary Education were more likely to have untimely EID compared to those where the household head had no formal education (AOR = 4.5986 [95% CI: 1.01-20.95], PV 0.049) Conclusion: Timely EID among HEI remains low in Uganda, Ugandan HEIs continue to be at risk of acquiring HIV infection due to untimely EID. The study recommends reducing untimely EID through proactively identifying and following mothers with identified predisposing factors to untimely EID among HEIs families, as opposed to follow up of HEIs mothers who have already missed timely EID. In addition, this study noted that a number of HEIs receive EID before the recommended timeline which may lead to poor diagnosis especially if the infant contracted HIV at birth. Mothers to HEIs should be given enough information during antenatal and at birth to ensure that they follow the proper recommendations. Most of factors that have been identified in most studies to influence the timeliness of EID did not show any significant association with untimely EID in this study. This calls for an in-depth qualitative study to understand the dynamics in rural settings and how they may influence the timeliness of EID Andinda Maureen

2020-03-01T00:00:00Z