Family planning uptake and its associated factors among women of reproductive age in Uganda: An insight from the Uganda Demographic and Health Survey 2016

Despite the government efforts to reduce the high fertility levels and increase the uptake of family planning services in Uganda, family planning use was still low at 30% in 2020 which was the lowest in the East African region. This study was undertaken to determine the prevalence and factors associated with the uptake of family planning methods among women of reproductive age in Uganda. This community-based cross-sectional study utilized secondary data from the Uganda Demographic and Health Survey (UDHS) of 2016. The survey data was downloaded from the Measure Demographic Health Survey website after data use permission was granted. Data was collected from a representative sample of women of the reproductive age group (15-49 years) from all 15 regions in Uganda. A total of 19,088 eligible women were interviewed but interviews were completed with 18,506 women. Data analysis was performed using SPSS statistical software version 32.0 where univariable, bivariable, and multivariable analyses were conducted. The prevalence of family planning use was found to be 29.3% and that of modern contraceptive use was found to be 26.6%. Multivariable analysis showed higher odds of current family planning use among older women (40-44 years) (aOR = 2.09, 95% CI: 1.40-3.12); women who had attained the secondary level of education (aOR = 1.91, 95% CI: 1.32-2.76); those living in households with the highest wealth index (aOR = 1.87, 95% CI: 1.29-2.72); and awareness of the availability of family planning methods (aOR = 1.41, 95% CI: 1.17-1.72). In conclusion, the study suggests improving women's education attainment, socio-economic position, and awareness may help increase use in the population.

Prevalence and factors associated with delayed antiretroviral therapy initiation among adults with HIV in Alebtong district, Northern Uganda: A facility-based study

Globally, an estimated 36.7 million people were living with HIV (PLWH) and of these, 2.1 million were newly infected and 1.1 million died of AIDS in 2015. By 2016, only 67% of adults eligible for ART were enrolled in ART in Uganda. Delayed ART initiation has been shown to contribute to the continued transmission of HIV as well as to higher morbidity and mortality among persons living with HIV. Our study examined the prevalence and factors associated with delayed ART initiation among adults with HIV in Alebtong district, Northern Uganda. A cross-sectional study involving 432 adults living with HIV was conducted between March and June 2018 in Alebtong district. Quantitative data were collected using interviewer-administered questionnaires and desk reviews using a data extraction tool. A binary logistic regression using a hierarchical modelling technique was used at the multivariable level to determine associations at a 95% confidence interval and p<0.05 using SPSS Statistics software version 23.0. Overall, 432 participants were enrolled in the study, of whom 18.1% (78/432) had delayed ART initiation. After final adjustment, our key findings showed a significantly lower odds of delayed ART initiation among older respondents (aOR = 0.35, 95% CI: 0.16-0.76); adherence to HIV clinic appointments, (aOR = 0.06, 95% CI: 0.02-0.15); and linkage to the HIV clinic the same day HIV test was conducted (aOR = 0.21, 95% CI: 0.08-0.55). However, a significantly higher odds of delayed ART initiation was observed among those whose cultures do not support the use of ART (aOR = 10.62, 95% CI: 3.04-32.08). Reducing delayed ART initiation in the district requires strengthening the involvement of adolescents and young people in the HIVAIDS programming, scaling up the implementation of the same-day ART initiation policy, and addressing negative cultural beliefs affecting early ART initiation in the district.

Predictors of teenage pregnancy among girls aged 13-19 years in Uganda: a community based case-control study

BACKGROUND

Teenage pregnancy is a serious public health and social problem, with 95% occurring in developing countries. The aim of the study was to investigate the behavioural, familial and social factors associated with teenage pregnancy among girls aged 13-19 years in Lira District, Uganda.

METHODS

Primary data from a case-control study of teenage girls (aged 13-19 years) in Lira District, Uganda was analysed. A Structured questionnaire was administered using face-to-face interviews to collect data on 495 participants, identified through simple random sampling from 32 villages in two counties in Lira District. Data analyses were done using SPSS Statistics 23 for descriptive, bivariate (i.e. Chi-square tests) and multivariable analyses (i.e. logistics regression) used for determining independent associations.

RESULTS

A total of 495 teenage girls participated in the study, however, final analyses were undertaken for 480 respondents. At bivariable analysis, all variables except alcohol consumption were significantly associated with teenage pregnancy. Among the behavioural factors assessed, multivariable analyses showed that having multiple sexual partners, frequent sex and irregular contraceptive use increased the likelihood of teenage pregnancy. Among familial factors, being married was found to increase the likelihood of teenage pregnancy. Peer pressure, sexual abuse and lack of control over sex was observed to increase the likelihood of teenage pregnancy.

CONCLUSIONS

Demographic, behavioural, familial and social factors are important predictors of teenage pregnancy in Lira District. Interventions focussing on: retaining pregnant and married girls at school, information on sexual and reproductive health of teenage girls, improving access to and information about contraceptive use among teenage girls, improving socio-economic status of households, and law enforcement on sexual abuse among girls may come a long way to improving adolescent sexual and health services in the low-income settings.