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Abiyo J, Nabirye RC, Nambozo B, Mukunya D, Nantale R, Oguttu F, Wani S, Musaba MW, Tumuhamye J, Epuitai J. "I have come to remove it because of heavy bleeding": a mixed-methods study on early contraceptive implant removal and the underlying factors in eastern Uganda. Contracept Reprod Med 2024; 9:17. [PMID: 38627845 PMCID: PMC11020533 DOI: 10.1186/s40834-024-00279-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 03/29/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Early contraceptive implant removal without intentions to conceive predisposes women to unintended pregnancies.. Some of the unintended pregnancies end in unsafe abortions which further increases the risk of maternal mortality and morbidity. Therefore, we assessed the proportion of women who had early contraceptive implant removal. We also explored the reasons for early contraceptive implant removalamong women at Mbale Regional Referral Hospital in eastern Uganda. METHODS We conducted a sequential explanatory mixed methods study at Mbale Regional Referral Hospital between November 2022 to December 2022. For quantitative data, we performed a secondary analysis on data extracted from the integrated family planning registers. We used systematic random sampling to select 600 clients' serial numbers from the registers. The outcome variable was early contraceptive implant removal defined as removal of the implant by the woman before 18 months from the time of insertion. For qualitative data, we conducted 11 in-depth interviews among women who had come for contraceptive implant removal at the family planning clinic. We also conducted two key informant interviews with midwives working at the family planning unit. Quantitative data were analysed using Stata version 14.0 (Stata Corp LLC, College Station, Texas, USA) while qualitative data were analysed by thematic content analysis. RESULTS In this study, 15% (91/600) of the women discontinued contraceptive implants within 12 months, 29% (175/600) within 18 months, 38% (230/600) within 24 months and 40% (240/600) within 36 months of insertion. Among the women who discontinued contraceptive implant use, only 6.7% (40/600) switched to another family planning method. Out of the 175 women who removed contraceptive implants early, side effects 61.1% (107/175) desire to conceive 53.1% ( 93/175),, and gender-based violence 8.6% (15/175) were the major reasons for removal. From the qualitative interviews, the major reasons for early contraceptive implant removal were side effects such as heavy menstrualbleeding. CONCLUSION A third of women discontinued contraceptive implant use within 18 months. Addressing concerns regarding side effects and male partner disapproval of modern contraceptives may improve continued use of implants.
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Affiliation(s)
- Janet Abiyo
- Department of Nursing, Faculty of Health Sciences, Busitema University, Mbale, P.0 Box 1460, Uganda
| | - Rose Chalo Nabirye
- Department of Nursing, Faculty of Health Sciences, Busitema University, Mbale, P.0 Box 1460, Uganda
| | - Brendah Nambozo
- Department of Community and Public Health, Faculty of Health Sciences, Busitema University, Mbale, P.0 Box 1460, Uganda.
| | - David Mukunya
- Department of Community and Public Health, Faculty of Health Sciences, Busitema University, Mbale, P.0 Box 1460, Uganda
| | - Ritah Nantale
- Department of Community and Public Health, Faculty of Health Sciences, Busitema University, Mbale, P.0 Box 1460, Uganda
| | - Faith Oguttu
- Department of Community and Public Health, Faculty of Health Sciences, Busitema University, Mbale, P.0 Box 1460, Uganda
| | - Solomon Wani
- Department of Community and Public Health, Faculty of Health Sciences, Busitema University, Mbale, P.0 Box 1460, Uganda
| | - Milton W Musaba
- Department of Obstetrics and Gynaecology, Faculty of Health Sciences, Busitema University, Mbale, P.0 Box 1460, Uganda
- Busitema University Centre of Excellency for Maternal Reproductive and Child Health, Mbale, Uganda
| | - Josephine Tumuhamye
- Makerere University Hospital, Makerere University Kampala, Kampala, P.O.BOX 7062, Uganda
| | - Joshua Epuitai
- Department of Nursing, Faculty of Health Sciences, Busitema University, Mbale, P.0 Box 1460, Uganda
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Nabirye RC, Mbalinda SN, Epuitai J, Nawagi F, Namyalo S, Nove A, Bazirete O, Hughes K, Lopes SC, Turkmani S, Forrester M, Homer CSE. Perceptions of quality of care in Midwife-led Birth Centres (MLBCs) in Uganda: Why do women choose MLBCs over other options? Women Birth 2024; 37:101612. [PMID: 38615515 DOI: 10.1016/j.wombi.2024.101612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 03/20/2024] [Accepted: 03/22/2024] [Indexed: 04/16/2024]
Abstract
BACKGROUND Midwife-led birth centres (MLBCs) are associated with reduced childbirth interventions, higher satisfaction rates, and improved birth outcomes. The evidence on quality of care in MLBCs from low and middle-income countries (LMIC) is limited. AIM This study aimed to explore the perceptions of women and midwives regarding the quality of care in four MLBCs in Uganda. METHODS A qualitative study was conducted in four MLBCs in Uganda. We conducted interviews with women and midwives in the MLBCs to explore their perceptions and experiences related to care in the MLBCs. The study obtained ethical approval. Deductive thematic analysis was used for data analysis. RESULTS Three key themes were identified regarding the perceptions of women and midwives about the quality of care in the MLBCs: providing respectful, and dignified care; a focus on woman-centred care; and reasons for choosing care in the MLBC. Women valued the respectful and humane care characterised by dignified and non-discriminatory care, non-abandonment, privacy, and consented care. The woman-centred care in the MLBC involved individualised holistic care, providing autonomy and empowerment, continuity of care, promoting positive birth experience, confidence in the woman's own abilities, and responsive providers. Women chose MLBCs because the services were perceived to be available, accessible, affordable, with comprehensive and effective referral mechanisms. CONCLUSION Women perceived care to be respectful, woman-centred, and of good quality. Global attention should be directed to scaling up the establishment of MLBCs, especially in LMIC, to improve the positive childbirth experience and increase access to care.
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Affiliation(s)
| | | | | | | | - Sarah Namyalo
- Uganda Private Midwives Association, Kampala, Uganda
| | | | - Oliva Bazirete
- Novametrics Ltd, Duffield, United Kingdom; University of Rwanda, Kigali, Rwanda
| | | | | | - Sabera Turkmani
- Faculty of Health, University of Technology Sydney, Sydney, Australia; Burnet Institute, Melbourne, Australia
| | - Mandy Forrester
- International Confederation of Midwives, The Hague, Netherlands
| | - Caroline S E Homer
- Faculty of Health, University of Technology Sydney, Sydney, Australia; Burnet Institute, Melbourne, Australia
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Callander EJ, Scarf V, Nove A, Homer C, Carrandi A, Abdullah AS, Clow S, Halim A, Mbalinda SN, Nabirye RC, Rahman AF, Rasheed SI, Turk AM, Bazirete O, Turkmani S, Forrester M, Mandke S, Pairman S, Boyce M. Midwife-led birthing centres in Bangladesh, Pakistan and Uganda: an economic evaluation of case study sites. BMJ Glob Health 2024; 9:e013643. [PMID: 38548343 PMCID: PMC10982789 DOI: 10.1136/bmjgh-2023-013643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 02/26/2024] [Indexed: 04/02/2024] Open
Abstract
INTRODUCTION Achieving the Sustainable Development Goals to reduce maternal and neonatal mortality rates will require the expansion and strengthening of quality maternal health services. Midwife-led birth centres (MLBCs) are an alternative to hospital-based care for low-risk pregnancies where the lead professional at the time of birth is a trained midwife. These have been used in many countries to improve birth outcomes. METHODS The cost analysis used primary data collection from four MLBCs in Bangladesh, Pakistan and Uganda (n=12 MLBC sites). Modelled cost-effectiveness analysis was conducted to compare the incremental cost-effectiveness ratio (ICER), measured as incremental cost per disability-adjusted life-year (DALY) averted, of MLBCs to standard care in each country. Results were presented in 2022 US dollars. RESULTS Cost per birth in MLBCs varied greatly within and between countries, from US$21 per birth at site 3, Bangladesh to US$2374 at site 2, Uganda. Midwife salary and facility operation costs were the primary drivers of costs in most MLBCs. Six of the 12 MLBCs produced better health outcomes at a lower cost (dominated) compared with standard care; and three produced better health outcomes at a higher cost compared with standard care, with ICERs ranging from US$571/DALY averted to US$55 942/DALY averted. CONCLUSION MLBCs appear to be able to produce better health outcomes at lower cost or be highly cost-effective compared with standard care. Costs do vary across sites and settings, and so further exploration of costs and cost-effectiveness as a part of implementation and establishment activities should be a priority.
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Affiliation(s)
- Emily J Callander
- Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Vanessa Scarf
- Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | | | | | - Alayna Carrandi
- Monash University School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia
| | | | - Sheila Clow
- University of Cape Town, Cape Town, South Africa
| | - Abdul Halim
- Centre for Injury Prevention and Research, Dhaka, Bangladesh
| | | | | | | | | | | | - Oliva Bazirete
- Novametrics Ltd, Duffield, UK
- University of Rwanda, Kigali, Rwanda
| | - Sabera Turkmani
- Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
- Burnet Institute, Melbourne, Victoria, Australia
| | - Mandy Forrester
- International Confederation Of Midwives, The Hague, The Netherlands
| | - Shree Mandke
- International Confederation Of Midwives, The Hague, The Netherlands
| | - Sally Pairman
- International Confederation Of Midwives, The Hague, The Netherlands
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Bazirete O, Hughes K, Lopes SC, Turkmani S, Abdullah AS, Ayaz T, Clow SE, Epuitai J, Halim A, Khawaja Z, Mbalinda SN, Minnie K, Nabirye RC, Naveed R, Nawagi F, Rahman F, Rasheed SI, Rehman H, Nove A, Forrester M, Mandke S, Pairman S, Homer CSE. Midwife-led birthing centres in four countries: a case study. BMC Health Serv Res 2023; 23:1105. [PMID: 37848936 PMCID: PMC10583445 DOI: 10.1186/s12913-023-10125-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 10/06/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND Midwives are essential providers of primary health care and can play a major role in the provision of health care that can save lives and improve sexual, reproductive, maternal, newborn and adolescent health outcomes. One way for midwives to deliver care is through midwife-led birth centres (MLBCs). Most of the evidence on MLBCs is from high-income countries but the opportunity for impact of MLBCs in low- and middle-income countries (LMICs) could be significant as this is where most maternal and newborn deaths occur. The aim of this study is to explore MLBCs in four low-to-middle income countries, specifically to understand what is needed for a successful MLBC. METHODS A descriptive case study design was employed in 4 sites in each of four countries: Bangladesh, Pakistan, South Africa and Uganda. We used an Appreciative Inquiry approach, informed by a network of care framework. Key informant interviews were conducted with 77 MLBC clients and 33 health service leaders and senior policymakers. Fifteen focus group discussions were used to collect data from 100 midwives and other MLBC staff. RESULTS Key enablers to a successful MLBC were: (i) having an effective financing model (ii) providing quality midwifery care that is recognised by the community (iii) having interdisciplinary and interfacility collaboration, coordination and functional referral systems, and (iv) ensuring supportive and enabling leadership and governance at all levels. CONCLUSION The findings of this study have significant implications for improving maternal and neonatal health outcomes, strengthening healthcare systems, and promoting the role of midwives in LMICs. Understanding factors for success can contribute to inform policies and decision making as well as design tailored maternal and newborn health programmes that can more effectively support midwives and respond to population needs. At an international level, it can contribute to shape guidelines and strengthen the midwifery profession in different settings.
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Affiliation(s)
- Oliva Bazirete
- College of Medicine and Health, Sciences, University of Rwanda, Kigali, Rwanda.
- Novametrics Ltd, Duffield, UK.
| | | | | | | | - Abu Sayeed Abdullah
- Centre for Injury Prevention and Research, Bangladesh (CIPRB), Dhaka, Bangladesh
| | | | | | | | - Abdul Halim
- Centre for Injury Prevention and Research, Bangladesh (CIPRB), Dhaka, Bangladesh
| | | | | | - Karin Minnie
- University of the Western Cape, Cape Town, South Africa
| | | | - Razia Naveed
- Research & Development Solutions, Islamabad, Pakistan
| | | | - Fazlur Rahman
- Centre for Injury Prevention and Research, Bangladesh (CIPRB), Dhaka, Bangladesh
| | | | - Hania Rehman
- Research & Development Solutions, Islamabad, Pakistan
| | | | - Mandy Forrester
- International Confederation of Midwives, The Hague, Netherlands
| | - Shree Mandke
- International Confederation of Midwives, The Hague, Netherlands
| | - Sally Pairman
- International Confederation of Midwives, The Hague, Netherlands
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Tekakwo A, Nabirye RC, Nantale R, Oguttu F, Nambozo B, Wani S, Musaba MW, Mukunya D, Epuitai J. Enablers and barriers of male involvement in the use of modern family planning methods in Eastern Uganda: a qualitative study. Contracept Reprod Med 2023; 8:49. [PMID: 37845730 PMCID: PMC10577923 DOI: 10.1186/s40834-023-00251-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 10/03/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND Male involvement plays a critical role in the utilization of various sexual and reproductive health services. We explored enablers and barriers of male involvement in the use of modern family planning methods in Eastern Uganda. METHODS This was a qualitative study in Mbale, Eastern Uganda done between November and December 2022. We conducted three group discussions comprising of four participants each, with male partners and eight key informant interviews with midwives. We followed a group discussion guide during the group discussions and an interview guide during the key informant interviews to explore enablers and barriers of male involvement in the use of modern family planning methods. All the interviews and group discussions were audio-recorded with permission from the participants, transcribed verbatim, and analyzed following thematic content analysis approach. RESULTS Two sub-themes emerged from the analysis; perceived enablers and barriers. The perceived enablers included positive attitude, subjective norms, need to support the woman, mutual consent, limited resources and expected benefits of reducing gender-based violence and sexually transmitted infections. Lack of male partner consent, busy work engagement, social stigma, religious prohibition, desire for many children and gender roles incompatibility hindered male partner involvement in family planning. Fear of side effects and misconceptions, unconducive hospital environment in form of mistreatment, family planning considered a female's issue, and lack of consideration of male partner needs in family planning clinic were additional barriers to male involvement. CONCLUSION Male involvement in family planning was related to positive attitude and subjective norms towards family planning, mutual consent, and recognition for limited resources to support a large family size. Lack of male partner approval, fear of side effects and misconceptions, unconducive hospital environment and social, cultural and religious prohibitions discouraged male partner involvement in family planning. Community based approaches to family planning sensitization, such as community education campaigns, may be an important step toward reducing barriers to male involvement in the use of modern family planning methods.
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Affiliation(s)
- Atkinson Tekakwo
- Department of Nursing, Faculty of Health Sciences, Busitema University, Mbale, Uganda
| | - Rose Chalo Nabirye
- Department of Nursing, Faculty of Health Sciences, Busitema University, Mbale, Uganda
| | - Ritah Nantale
- Department of Community and Public Health, Faculty of Health Sciences Mbale, Busitema University, Mbale, Uganda.
- Busitema University Centre of Excellence for Maternal, Reproductive and Child Health, Mbale, Uganda.
| | - Faith Oguttu
- Department of Community and Public Health, Faculty of Health Sciences Mbale, Busitema University, Mbale, Uganda
| | - Brendah Nambozo
- Department of Community and Public Health, Faculty of Health Sciences Mbale, Busitema University, Mbale, Uganda
| | - Solomon Wani
- Department of Community and Public Health, Faculty of Health Sciences Mbale, Busitema University, Mbale, Uganda
| | - Milton W Musaba
- Department of Obstetrics and Gynecology, Faculty of Health Sciences, Busitema University, Mbale, Uganda
- Busitema University Centre of Excellence for Maternal, Reproductive and Child Health, Mbale, Uganda
| | - David Mukunya
- Department of Community and Public Health, Faculty of Health Sciences Mbale, Busitema University, Mbale, Uganda
- Busitema University Centre of Excellence for Maternal, Reproductive and Child Health, Mbale, Uganda
- Department of Research, Nikao Medical Center, Kampala, Uganda
| | - Joshua Epuitai
- Department of Nursing, Faculty of Health Sciences, Busitema University, Mbale, Uganda
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Sarah Maria N, Olwit C, Kaggwa MM, Nabirye RC, Ngabirano TD. Cervical cancer screening among HIV-positive women in urban Uganda: a cross sectional study. BMC Womens Health 2022; 22:148. [PMID: 35538482 PMCID: PMC9092766 DOI: 10.1186/s12905-022-01743-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 04/28/2022] [Indexed: 11/10/2022] Open
Abstract
Background Women living with Human Immunodeficiency Virus (HIV) are at a high risk for early development of cervical cancer. Adherence to cervical cancer prevention strategies in this population is vital for the early detection and treatment of cervical cancer. This study aimed to determine the prevalence and factors associated with cervical cancer screening among HIV-positive women attending an urban HIV care center in Uganda. Methods This cross-sectional study included 205 HIV-positive women receiving care at an urban HIV care center. An interviewer-administered questionnaire was used to capture sociodemographic information, history of screening for cervical cancer, and reproductive health characteristics. Logistic regression analysis was used to determine the factors associated with cervical cancer screening. Results Of the 205 HIV-positive women with a mean age of 37.5 ± 8.87 that participated in the study, majority (n = 201, 98%) were aware of cervical cancer screening. Ninety participants (44%) had ever been screened for cervical cancer and only 33 (16.1%) had been screened in the past year. Obtaining information about cancer of the cervix and cervical cancer screening from health care professionals was significantly associated with higher levels of cervical cancer screening (adjusted odds ratio = 5.61, 95% confidence interval: 2.50–12.61, p value < 0.001). Conclusion This study highlights the low prevalence of cervical cancer screening among HIV-positive women and underscores the role of health professionals as an effective source of information on cervical cancer and cervical cancer screening. Patient education programs in HIV prevention and care facilities should emphasize cervical cancer screening messages to enhance the uptake of screening services.
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Affiliation(s)
| | - Connie Olwit
- Department of Nursing, School of Health Sciences, College of Health Sciences Makerere University, Kampala, Uganda
| | - Mark Mohan Kaggwa
- Department of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | | | - Tom Denis Ngabirano
- Department of Nursing, School of Health Sciences, College of Health Sciences Makerere University, Kampala, Uganda
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Telfer M, Zaslow R, Chalo Nabirye R, Nalugo Mbalinda S. Review of midwifery education in Uganda: Toward a framework for integrated learning and midwifery model of care. Midwifery 2021; 103:103145. [PMID: 34607055 DOI: 10.1016/j.midw.2021.103145] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 08/31/2021] [Accepted: 09/05/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To examine the current approach to midwifery education and deployment in Uganda against the backdrop of the evidence presented in the Lancet Series on Midwifery and the International Confederation of Midwives Global Standards for Midwifery Education. To make a distinction between 'Midwifery Model of Care' and training in maternal health nursing and highlight the need for midwifery education that is in alignment with international standards and reflexive to the realities of the Ugandan clinical context. SETTING/PARTICIPANTS A review of Ugandan nursing and midwifery education structure, curricula and current workforce configurations. A review of government reports and published literature regarding nursing and midwifery education. FINDINGS The pathways for nursing and midwifery education in Uganda are too numerous and without clear pathways for educational advancement. The scope of practice for new graduates is not realistic to the context midwives will practice in. Overall, nursing and midwifery education curricula does not prepare graduates to International Confederation of Midwives Standards and lacks training and mentorship in the 'Midwifery Model of Care' making graduates closer to 'maternity nurses' than midwives. KEY CONCLUSIONS The Ugandan midwifery education curricula and model needs to bring education standards into alignment with International Confederation of Midwives such that midwives are equipped to practice using the Quality Maternal Newborn Care Framework. Until this is accomplished maternal and newborn mortality rates will remain high, Uganda will continue to lose one of it's greatest resources, it's human capital, and the Sustainable Development Goal 3 will remain out of reach.
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Affiliation(s)
- Michelle Telfer
- Midwifery Specialty, Yale School of Nursing, West Haven, CT, United States.
| | - Rachel Zaslow
- Midwifery Specialty, Yale School of Nursing, West Haven, CT, United States
| | - Rose Chalo Nabirye
- Department of Nursing, Faculty of Health Sciences, Busitema University, Tororo, Uganda
| | - Scovia Nalugo Mbalinda
- Department of Nursing, School of Health Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
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Bakesiima R, Cleeve A, Larsson E, Tumwine JK, Ndeezi G, Danielsson KG, Nabirye RC, Kashesya JB. Modern contraceptive use among female refugee adolescents in northern Uganda: prevalence and associated factors. Reprod Health 2020; 17:67. [PMID: 32434523 PMCID: PMC7238518 DOI: 10.1186/s12978-020-00921-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 05/11/2020] [Indexed: 11/18/2022] Open
Abstract
Background Adolescent pregnancies are persistently high among refugees. The pregnancies have been attributed to low contraceptive use in this population. The aim of this study was to determine the prevalence and factors associated with modern contraceptive use among female refugee adolescents in northern Uganda. Methods This was a cross sectional study using both descriptive and analytical techniques. The study was carried out in Palabek refugee settlement in Northern Uganda from May to July 2019. A total of 839 refugee adolescents who were sexually active or in-union were consecutively enrolled. Interviewer administered questionnaires were used for data collection. Results Modern contraceptive prevalence was 8.7% (95% CI: 7.0 to 10.8). The injectable was the most commonly used modern contraceptive method [42.5% (95% CI: 31.5 to 54.3)], and most of the participants had used the contraceptives for 6 months or less (59.7%). Reasons for not using modern contraceptives included fear of side effects (39.3%), partner prohibition (16.4%), and the desire to become pregnant (7.0%). Participants who were married (OR = 0.11, 95% CI: 0.04 to 0.35, p < 0.001), cohabiting (OR = 0.43, 95% CI: 0.20 to 0.93, p = 0.032) or having an older partner (OR = 0.93, 95% CI: 0.86 to 0.99, p = 0.046) were less likely to use modern contraceptives. Conclusion Modern contraceptive use among female refugee adolescents was very low, and few reported a desire to become pregnant, leaving them vulnerable to unplanned pregnancies. Least likely to use modern contraceptives were participants who were married/cohabiting and those having older partners implying a gender power imbalance in fertility decision making. There is an urgent need for innovations to address the gender and power imbalances within relationships, which could shape fertility decision-making and increase modern contraceptive use among refugee adolescents.
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Affiliation(s)
- Ritah Bakesiima
- Department of Obstetrics and Gynaecology, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda. .,Department of Women's and Children's Health, Division of Obstetrics and Gynaecology, Karolinska Institutet, and Karolinska University Hospital, Stockholm, Sweden.
| | - Amanda Cleeve
- Department of Women's and Children's Health, Division of Obstetrics and Gynaecology, Karolinska Institutet, and Karolinska University Hospital, Stockholm, Sweden
| | - Elin Larsson
- Department of Women's and Children's Health, Division of Obstetrics and Gynaecology, Karolinska Institutet, and Karolinska University Hospital, Stockholm, Sweden.,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - James K Tumwine
- Department of Paediatrics and Child health, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Grace Ndeezi
- Department of Paediatrics and Child health, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Kristina Gemzell Danielsson
- Department of Women's and Children's Health, Division of Obstetrics and Gynaecology, Karolinska Institutet, and Karolinska University Hospital, Stockholm, Sweden
| | - Rose Chalo Nabirye
- Department of Nursing, School of Health Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Jolly Beyeza Kashesya
- Department of Obstetrics and Gynaecology, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
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Abstract
Purpose– The purpose of this paper is to assess the levels of awareness and knowledge about oral cancer, its causes and or risk factors among Ugandan patients seeking oral healthcare. Design/methodology/approach– This was a cross-sectional study on adult patients who attended a free dental camp. An assistant-administered questionnaire either in English or Luganda was provided to every even-numbered registered adult who consented to participate in the study. Information on demographics and known risk factors for oral cancer were captured. The two knowledge questions on oral cancers were scored by adding up all the correctly identified causes, non-causes and risk factors then scored out of the total. Data analysis was done by calculating proportions, Student’s’ t-tests and χ2 tests with significant p-value set at 0.05. Findings– The results showed a low level of awareness/knowledge about oral cancer in studied population. In total, 60 percent and less than 50 percent of respondents identified smoking and alcohol use as risk factors for oral cancer, respectively. Majority of respondents (88.8 percent) would seek help from medical personnel if diagnosed with oral cancer. Screening for cancer was low despite awareness and knowledge that it improves the chances of successful treatment. Research limitations/implications– Emphasis on risk factors including alcohol use in public health messages, use of mass media, religious and community leaders to disseminate messages to the communities and further research were recommended. Practical implications– We need to emphasize the role of alcohol in oral cancer causation just as we do for tobacco consumption. Originality/value– No study has been conducted in Uganda on the level of awareness yet the incidence of the disease and use of high-risk products are rising.
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Abstract
BACKGROUNDNurses and midwives form the backbone of health service delivery and satisfaction with care often depends on the competencies of nurses and midwives who provide the care (World Health Organization [WHO], 2002). Healthcare has become complex, challenging, and demanding across diverse sociocultural and socioeconomic changes and environments. To optimize their impact, nurses and midwives therefore need to be prepared with evidence-based competences. Nursing research therefore, is the cornerstone for evidence-based practice and for establishing the professional status of nursing and building research capacity. However, although nursing research began in the 19th century, it is limited in Africa, with little evidence generated to inform policy and practice. Although nursing and midwifery education in the region has advanced with graduate and postgraduate level education, little is known about nursing and midwifery research conducted in universities and where to find such research.OBJECTIVESThe literature review aimed at quantifying and identifying the types and gaps in nursing and midwives' research and publications in Africa.METHODSArticles published between January 1, 2007 and January 31, 2017 were retrieved from PubMed and Cumulative Index to Nursing and Allied Health Literature (CINAHL) with a search strategy that employed four sets of terms: (a) terms identifying published research done by nurses or midwives, or both; (b) terms identifying types of publications; (c) terms identifying filters for African countries; and (d) filters for publication dates. We also searched Google Scholar to capture nonindexed sources.RESULTS AND CONCLUSIONSThere is evidence of an increasing number of African nurses and midwives publishing research; however, much of this research may not be readily available. The promotion of nursing research and capacity building/mentorship in research for nurses and midwives is recommended to increase nurses' and midwives' skills to critically evaluate research and apply the best evidence to their practice.
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Olwit C, Mugaba M, Osingada CP, Nabirye RC. Existence, triggers, and coping with chronic sorrow: a qualitative study of caretakers of children with sickle cell disease in a National Referral Hospital in Kampala, Uganda. BMC Psychol 2018; 6:50. [PMID: 30342559 PMCID: PMC6196010 DOI: 10.1186/s40359-018-0263-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 10/09/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Worldwide, sickle cell disease is recognized as one of the major causes of morbidity and mortality. Caregivers and patients with such chronic illnesses experience economic, physical, social and psychological distresses which may lead to chronic sorrow. Chronic sorrow is viewed as a normal reaction to loss, however it can progress to a pathological state such as depression if the coping styles are ineffective. Therefore, the aim of this study was to explore the existence of chronic sorrow, triggers and coping with grief related feelings among caretakers of children with sickle cell disease. METHODS A descriptive qualitative study was conducted. Twelve in-depth interviews were conducted with eligible participants who were purposively selected. Deductive thematic analysis methods were used for data analysis. RESULTS Many (9 out of 12) of the caretakers experienced chronic sorrow. The grief related feelings were triggered by health worker related, disease related and support related factors. Caretakers used both external and internal coping strategies. External support was derived from community, family and health facility. Internal coping strategies were behavioral and cognitive. CONCLUSION Caretakers of children with sickle cell disease experienced chronic sorrow and employed both internal and external coping strategies to deal with it, which could be either effective or ineffective. This study recommends that health workers should routinely screen for chronic sorrow among caretakers of children with sickle cell disease and assist caretakers to strengthen effective coping strategies to ameliorate the negative effects of chronic sorrow.
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Affiliation(s)
- Connie Olwit
- Department of Nursing, College of health sciences, Makerere University, P.O.BOX. 7072, Kampala, Uganda.
| | - Maureen Mugaba
- Department of Nursing, College of health sciences, Makerere University, P.O.BOX. 7072, Kampala, Uganda
| | - Charles Peter Osingada
- Department of Nursing, College of health sciences, Makerere University, P.O.BOX. 7072, Kampala, Uganda
| | - Rose Chalo Nabirye
- Department of Nursing, College of health sciences, Makerere University, P.O.BOX. 7072, Kampala, Uganda
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Osingada CP, Okuga M, Nabirye RC, Sewankambo NK, Nakanjako D. Disclosure of Parental HIV Status to Children: Experiences of Adults Receiving Antiretroviral Treatment at an Urban Clinic in Kampala, Uganda. AIDS Res Treat 2017; 2017:3458684. [PMID: 29209538 PMCID: PMC5676343 DOI: 10.1155/2017/3458684] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 09/28/2017] [Indexed: 11/24/2022] Open
Abstract
Limited data are available on the experiences of parental HIV disclosure to children in Uganda. We conducted a qualitative study comprising sixteen in-depth interviews and four focus group discussions with parents receiving highly active antiretroviral therapy. Analysis was done using Atlas.ti qualitative research software. Back-and-forth triangulation was done between transcripts of the in-depth interviews and focus group discussions, and themes and subthemes were developed. Barriers to parents' disclosure included perceptions that children are too young to understand what HIV infection means and fears of secondary disclosure by the children. Immediate outcomes of disclosure included children getting scared and crying, although such instances often gave way to more enduring positive experiences for the parents, such as support in adherence to medical care, help in household chores, and a decrease in financial demands from the children. Country-specific interventions are needed to improve the process of parental HIV disclosure to children and this should encompass preparation on how to deal with the immediate psychological challenges associated with the parent's disclosure.
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Affiliation(s)
- Charles Peter Osingada
- Makerere University College of Health Sciences, School of Health Sciences, Department of Nursing, P.O. Box 7072, Kampala, Uganda
| | - Monica Okuga
- Makerere University School of Public Health, Department of Health Policy Planning and Management, P.O. Box 7072, Kampala, Uganda
| | - Rose Chalo Nabirye
- Makerere University College of Health Sciences, School of Health Sciences, Department of Nursing, P.O. Box 7072, Kampala, Uganda
| | - Nelson Kaulukusi Sewankambo
- Department of Internal Medicine, School of Medicine, Makerere College of Health Sciences, P.O. Box 7072, Kampala, Uganda
| | - Damalie Nakanjako
- Department of Internal Medicine, School of Medicine, Makerere College of Health Sciences, P.O. Box 7072, Kampala, Uganda
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Rinne J, Nabacwa ON, Nabirye RC, Shorten A. Impact of High Patient Volume on Midwifery Education in Kampala, Uganda. J Midwifery Womens Health 2017. [DOI: 10.1111/jmwh.12687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Mbalinda SN, Nabirye RC, Ombeva EA, Brown SD, Leffers JM. Nursing Partnership Activities, Components, and Outcomes: Health Volunteers Overseas in Uganda 2001-2016. Front Public Health 2017; 5:173. [PMID: 28770193 PMCID: PMC5509790 DOI: 10.3389/fpubh.2017.00173] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 06/29/2017] [Indexed: 11/15/2022] Open
Abstract
Nurses increasingly form global health partnerships through academic and voluntary organizations that are designed to improve health outcomes. Many such partnerships are funded for specific time periods and have short- or long-term goals to achieve during the partnership. Other partnerships are sustained for longer periods of time through the efforts of partners committed to their joint work. The case example of the Health Volunteers Overseas Nursing Education partnership in Kampala, Uganda, demonstrates key components of partnerships that promote sustainability of programs. This case example is analyzed using literature that reports partnership models to identify those factors that have led to sustainability. Additionally, both objective and subjective program outcomes are reported. Recommendations for further evaluation are included.
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Affiliation(s)
| | - Rose Chalo Nabirye
- Department of Nursing, School of Health Sciences, Makerere University, Kampala, Uganda
| | | | - S Danielle Brown
- Barrow Neurological Institute at Phoenix Children's Hospital, Phoenix, AZ, United States
| | - Jeanne M Leffers
- Department of Community Nursing, University of Massachusetts Dartmouth, Dartmouth, MA, United States
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Nakimuli A, Nakubulwa S, Kakaire O, Osinde MO, Mbalinda SN, Kakande N, Nabirye RC, Kaye DK. The burden of maternal morbidity and mortality attributable to hypertensive disorders in pregnancy: a prospective cohort study from Uganda. BMC Pregnancy Childbirth 2016; 16:205. [PMID: 27492552 PMCID: PMC4973370 DOI: 10.1186/s12884-016-1001-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 07/30/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hypertensive disorders of pregnancy are a major cause of morbidity and mortality. The objective was to estimate the disease burden attributable to hypertensive disorders of pregnancy in two referral hospitals in Uganda. METHODS Through a prospective cohort study conducted in Jinja and Mulago hospitals in Uganda from March 1, 2013 and February 28, 2014, hypertension-related cases were analyzed. Maternal near miss cases were defined according to the WHO criteria. Maternal deaths were also analyzed. The maternal near miss incidence ratio, the case-specific severe maternal outcome ratio, the case-specific maternal mortality ratio and the case-fatality ratio were computed. RESULTS Of 403 women with hypertensive disorders of pregnancy, 218 (54.1 %) had severe preeclampsia, 172 (42.7 %) had eclampsia, and 13 had chronic hypertension or Hemolysis, elevated liver enzymes or low platelets (HELLP) syndrome. The case-specific maternal near miss incidence ratios was 8.60 per 1,000 live births for all hypertensive disorders, 3.06 per 1,000 live births for severe preeclampsia and 5.11 per 1,000 live births for eclampsia. The case-specific severe maternal outcome ratio was 9.37 per 1,000 live births for all hypertensive disorders, and was 3.25 per 1,000 live births for severe preeclampsia and 5.61 per 1,000 live births for eclampsia. The case-specific maternal mortality ratio was 780 per 100,000 live births for all hypertensive disorders, and was 1940 per 100,000 live births for severe preeclampsia and 501 per 100,000 live births for eclampsia. The case-fatality ratio was 5.1 % overall (for all hypertensive disorders), but was 8 times higher for eclampsia compared to severe preeclampsia. Cyanosis, abnormal respiration, oliguria, circulatory collapse, coagulopathy, thrombocytopenia, and elevated serum lactate were significantly associated with severe maternal outcomes. CONCLUSION There is high morbidity attributable to hypertensive disorders in pregnancy. Since some of the complications associated with morbidity can be recognized early, it is possible to prevent severe morbidity through early intervention with delivery, antihypertensive therapy and prophylactic magnesium sulphate treatment. The findings highlight the feasibility of implementing a facility-based surveillance system for severe maternal morbidity due to hypertensive disorders.
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Affiliation(s)
- Annettee Nakimuli
- Department of Obstetrics and Gynecology, School of Medicine, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda
| | - Sarah Nakubulwa
- Department of Obstetrics and Gynecology, School of Medicine, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda
| | - Othman Kakaire
- Department of Obstetrics and Gynecology, School of Medicine, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda
| | | | - Scovia Nalugo Mbalinda
- Department of Nursing, School of Health Sciences, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda
| | - Nelson Kakande
- Clinical, Operations and Health Services Research Program, Joint Clinical Research Centre, P. O. Box 10005, Kampala, Uganda
| | - Rose Chalo Nabirye
- Department of Nursing, School of Health Sciences, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda
| | - Dan Kabonge Kaye
- Department of Obstetrics and Gynecology, School of Medicine, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda.
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Osingada CP, Okuga M, Nabirye RC, Sewankambo NK, Nakanjako D. Prevalence, barriers and factors associated with parental disclosure of their HIV positive status to children: a cross-sectional study in an urban clinic in Kampala, Uganda. BMC Public Health 2016; 16:547. [PMID: 27401865 PMCID: PMC4940877 DOI: 10.1186/s12889-016-3235-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 06/28/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Disclosure of parental HIV status is associated with a number of positive outcomes such as improved adherence to clinic appointments, lower levels of parental anxiety and depression, and mutual emotional support between parents and their children. Very few studies in low-resource settings have addressed the issues of parental disclosure of their HIV status to their children. METHODS A cross-sectional study was conducted among adult parents attending HIV/AIDS prevention, care and treatment clinic at Makerere University Infectious Diseases Institute (IDI), Kampala, Uganda. Participants were interviewed using the Parent Disclosure Interview (PDI) questionnaire which is a standard tool developed specifically for HIV infected parents. Data were analyzed using STATA version 13.1. RESULTS Of 344 participants, only 37 % had told at least one of their children that they were HIV positive. Barriers to disclosure were fear that children may tell other people about the parent's HIV status, desire not to worry or upset children and perceptions that children may not understand. Age of the parent, religion and having someone committed to care of the children were positively associated with parental disclosure of their HIV positives status. Attainment of tertiary level of education was negatively associated with parental disclosure of their HIV status. CONCLUSIONS Parental disclosure of a positive HIVstatus to their children is still low in urban Kampala. There is therefore need to develop locally relevant interventions so as to increase rates of parental disclosure of a positive HIV status to their children and thus promote open and honest discussions about HIV/AIDS at family level.
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Affiliation(s)
- Charles Peter Osingada
- Department of Nursing, Makerere University College of Health Sciences, School of Health Sciences, P.O. Box 7072, Kampala, Uganda.
| | - Monica Okuga
- Department of Health Policy planning and Management, Makerere University School of Public Health, P.O. Box 7072, Kampala, Uganda
| | - Rose Chalo Nabirye
- Department of Nursing, Makerere University College of Health Sciences, School of Health Sciences, P.O. Box 7072, Kampala, Uganda
| | - Nelson Kaulukusi Sewankambo
- Department of Internal Medicine, School of Medicine, Makerere College of Health Sciences, P.O. Box 7072, Kampala, Uganda
| | - Damalie Nakanjako
- Department of Internal Medicine, School of Medicine, Makerere College of Health Sciences, P.O. Box 7072, Kampala, Uganda
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Hasahya OT, Berggren V, Sematimba D, Nabirye RC, Kumakech E. Beliefs, perceptions and health-seeking behaviours in relation to cervical cancer: a qualitative study among women in Uganda following completion of an HPV vaccination campaign. Glob Health Action 2016; 9:29336. [PMID: 26895145 PMCID: PMC4759844 DOI: 10.3402/gha.v9.29336] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 12/08/2015] [Accepted: 12/21/2015] [Indexed: 01/12/2023] Open
Abstract
Background Cervical cancer remains a leading cause of morbidity and mortality in Uganda. Despite earlier information campaigns to introduce human papilloma virus (HPV) vaccination, which also targeted cervical cancer, misinterpretation and misunderstanding of the subject remain high. Women in Uganda present with cervical cancer at an advanced stage due to poor health-seeking behaviours, with an associated high mortality rate. This project explored beliefs, attitudes, perceptions, and health-seeking behaviours in relation to cervical cancer among women in Uganda after an HPV vaccination project had been rolled out. Design A qualitative study design was used, with six focus group discussions (FGDs) that included 36 women, aged 25–49 years, with no previous history of cervical cancer symptoms or diagnosis. The women were interviewed in February and March 2013. The transcribed data was analysed using content analysis. Results Three themes emerged: feeling unprotected and unsafe, misbelief and wondering about cervical cancer, and fear of the testing procedure. Participating women had heard of cervical cancer but preferred to wait to access cervical cancer screening until symptom debut. Conclusions There are still barriers to cervical cancer screening among women in Uganda, where there is a need for culture-specific, sensitive information and interventions to address the issues of improving the cervical cancer screening uptake among these women. Societal context needs to be taken into account when implementing community-based health education.
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Affiliation(s)
- Olivia Topister Hasahya
- Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden.,Gynecological, Breast and Sarcoma Cancer, Department of Oncology, Karolinska University Hospital, Solna, Sweden;
| | - Vanja Berggren
- Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden.,Faculty of Health Sciences, Lund University, Lund, Sweden
| | - Douglas Sematimba
- Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden.,Makerere University College of Health Sciences, Kampala, Uganda
| | | | - Edward Kumakech
- Makerere University College of Health Sciences, Kampala, Uganda
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Kizza IB, Muliira JK, Kohi TW, Nabirye RC. Nurses’ knowledge of the principles of acute pain assessment in critically ill adult patients who are able to self-report. International Journal of Africa Nursing Sciences 2016. [DOI: 10.1016/j.ijans.2016.02.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
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Munabi IG, Buwembo W, Kitara DL, Ochieng J, Nabirye RC, Mwaka ES. Musculoskeletal disorders among nursing staff: a comparison of five hospitals in Uganda. Pan Afr Med J 2014; 17:81. [PMID: 25018829 PMCID: PMC4085942 DOI: 10.11604/pamj.2014.17.81.3213] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Accepted: 10/31/2013] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Low and middle income countries have severe nursing staff shortages which is associated with risk of poor quality of patient care and increased patient exposure to adverse events. This is accompanied with increased risk of musculoskeletal disorders to the nursing staff. This paper sets out to identify and compare factors associated with musculoskeletal disorders among nursing staff in 5 different hospitals in Uganda. METHODS This was a cross sectional study on nurses from 5 different hospitals in Uganda. The study used a 12 month recall of reported Musculoskeletal disorders (MSD) among nurses. Ethical approval was obtained. Logistic regression analysis and ANOVA were used. The level of significance was set at 0.05 for all statistical tests. RESULTS There were 755 respondents of whom 433 (58.4%) were nurses. The prevalence of MSD at anybody site was 80.8%. There were significant differences in reported MSD among nursing staff across different hospital settings which were worse in the public hospitals as compared to the private and private not for profit hospitals (p <0.001). Age (adjusted OR 1.03, 95% CI 1.01-1.06), self reported poor general health status (adj OR 4.5, 95% CI 2.8-7.24) and stress as suggested by waking up tired in the morning (adj OR 3.4, 95% CI 2.17-5.32) were significant associated factors for MSD in this population. CONCLUSION Reported MSD among nursing staff across 5 different hospitals is worse in public as compared to private hospitals. Age, self reported poor general health status and stress were important factors for MSD in this population.
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Affiliation(s)
- Ian Guyton Munabi
- Anatomy Department, School of Biomedical Sciences, Makerere University College of Health Sciences, Uganda
| | - William Buwembo
- Anatomy Department, School of Biomedical Sciences, Makerere University College of Health Sciences, Uganda
| | | | - Joseph Ochieng
- Anatomy Department, School of Biomedical Sciences, Makerere University College of Health Sciences, Uganda
| | - Rose Chalo Nabirye
- Department of Nursing, School of Medicine, Makerere University College of Health Sciences, Uganda
| | - Erisa Sabakaki Mwaka
- Anatomy Department, School of Biomedical Sciences, Makerere University College of Health Sciences, Uganda
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Njie-Carr V, Kalengé S, Kelley J, Wilson A, Muliira JK, Nabirye RC, Glass N, Bollinger R, Alamo-Talisuna S, Chang LW. Research capacity-building program for clinicians and staff at a community-based HIV clinic in Uganda: A pre/post evaluation. J Assoc Nurses AIDS Care 2012; 23:431-41. [PMID: 22265671 DOI: 10.1016/j.jana.2011.11.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2011] [Accepted: 11/03/2011] [Indexed: 11/15/2022]
Abstract
Developing capacity for HIV research and clinical practice is critically needed in resource-limited countries. The purpose of this study was to evaluate a research capacity-building program for community-based participants in the preparation and conduct of mobile phone-based technology interventions. A descriptive, cross-sectional design was used. Participants completed self-report surveys at three time points. Thirty-three participated in the situational analysis, and all (100%) felt that the research training was needed. For the interim evaluation, more than 96.8% (n = 30) reported increased knowledge and confidence and attributed this to the training. Fourteen participants completed the final evaluation. Dedicated time away from work was an important factor to facilitate recruitment and data collection, followed by financial incentives to commute to data collection sites. Expertise through supervision and mentorship for participants and sustained funding for research projects are critical to the innovation needed to improve HIV prevention and care outcomes.
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