BACKGROUND At the beginning of the COVID-19 pandemic, many low-income countries were confronted with a difficult challenge: with little resources and while implementing a stringent lockdown, they had to rapidly train thousands of... more
BACKGROUND At the beginning of the COVID-19 pandemic, many low-income countries were confronted with a difficult challenge: with little resources and while implementing a stringent lockdown, they had to rapidly train thousands of Community Health Workers (CHW) in rural and remote areas about the new virus and then find a way to continue to support them in providing health services and products. Shortly after the first COVID-19 case was confirmed in Uganda, a local consortium developed a telehealth approach that aimed to inform 3500 CHWs about COVID-19, support them in identifying, referring and caring for possible COVID-19 cases and help them to continue to provide basic health services and products. OBJECTIVE To assess the functioning of the telehealth approach that was set up to support community health workers in rural communities in Uganda with sustaining basic health services and dealing with the COVID-19 pandemic. METHODS For this mixed-method study, we combined analysis of 1)...
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Additional file 2: Training opportunities and scope of practices related to child health for mid-level health workers in Kenya, Uganda, Tanzania, Malawi and South Africa.
Additional file 1: Scoping review appendix.
Knowledge and attitudes towards use of long acting reversible contraceptives among women baga division, Kampala Contrary, the attitude that LARC was for married women was negatively associated with its use. This study suggests
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This article is published as part of the supplement "Field Epidemiology in Africa". Supplement sponsored by PAMJ and The African Field
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Background This is the first study to examine the costs of conducting a mobile phone survey (MPS) through interactive voice response (IVR) to collect information on risk factors for noncommunicable diseases (NCD) in three low- and... more
Background This is the first study to examine the costs of conducting a mobile phone survey (MPS) through interactive voice response (IVR) to collect information on risk factors for noncommunicable diseases (NCD) in three low- and middle-income countries (LMIC); Bangladesh, Colombia, and Uganda. Methods This is a micro-costing study conducted from the perspective of the payer/funder with a 1-year horizon. The study evaluates the fixed costs and variable costs of implementing one nationally representative MPS for NCD risk factors of the adult population. In this costing study, we estimated the sample size of calls required to achieve a population-representative survey and associated incentives. Cost inputs were obtained from direct economic costs incurred by a central study team, from country-specific collaborators, and from platform developers who participated in the deployment of these MPS during 2017. Costs were reported in US dollars (USD). A sensitivity analysis was conducted as...
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To investigate whether disclosure of HIV status is associated with use of modern contraceptives (MCs) among women attending HIV care services at an AIDS Information Center (AIC) in an urban setting in Uganda. In a cross-sectional study... more
To investigate whether disclosure of HIV status is associated with use of modern contraceptives (MCs) among women attending HIV care services at an AIDS Information Center (AIC) in an urban setting in Uganda. In a cross-sectional study between March and April 2010, HIV-positive married women aged 15-49years who had received their HIV-positive serostatus results at least 4weeks previously were interviewed at the AIC, Kampala, Uganda. Female use of MCs was compared by HIV disclosure to male marital partners. Log-binomial regression models were used to obtain crude and adjusted prevalence risk ratios (PRRs) and corresponding 95% confidence intervals (CIs). Nearly three-quarters (72.6%) of the women had disclosed their HIV-positive status to their partner. Overall, use of MCs was reported by 41.0% of the participants. Use of only 1 MC method was similar between those disclosing (81.1%) and those not disclosing (84.3%), but use of dual methods tended to be higher among disclosers (14.4%) than among non-disclosers (10.8%). In adjusted analyses, MC use was 41.0% lower among disclosers than among non-disclosers (adjusted PRR, 0.59; 95% CI, 0.46-0.77). HIV serostatus disclosure was associated with lower use of MCs among HIV-positive women in Kampala, Uganda.
Research Interests: Ethics, Contraception, Developing Countries, Health, Adolescent, and 15 moreMedicine, Humans, Female, Gynecology and Obstetrics, Male, Middle Aged, Adult, Hiv seropositivity, Cross Sectional Analysis, Confidential Information, Cross Sectional Studies, Marital Status, Paediatrics and reproductive medicine, HIV infections, and Contraceptive Agents
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Research Interests: Developing Countries, Adolescent, Maternal Health, Medicine, Multivariate Analysis, and 15 moreMaternal Mortality, Humans, Female, Male, Health information, Middle Aged, Adult, Cross Section, Infant Mortality, General Linear Model, Consumer Participation, Antenatal Care, Civil Conflict, Health Workers, and Cross Sectional Studies
Research Interests: Training and Development, Evidence Based Practice, Health Care, Strategic Planning, Public Health, and 15 moreMedicine, Quality of Care, Quality Assurance, Health Services, Communication Skill, Focus Group, Health Science, Service Delivery, Qualitative Study, Continuous professional development, Service provision, Public health systems and services research, Patient Care, Focus Group Discussion, and Health Outcome(Medicine, Quality of Care, Quality Assurance, Health Services, Communication Skill, Focus Group, Health Science, Service Delivery, Qualitative Study, Continuous professional development, Service provision, Public health systems and services research, Patient Care, Focus Group Discussion, and Health Outcome)
(Medicine, Quality of Care, Quality Assurance, Health Services, Communication Skill, Focus Group, Health Science, Service Delivery, Qualitative Study, Continuous professional development, Service provision, Public health systems and services research, Patient Care, Focus Group Discussion, and Health Outcome)
BackgroundDemographic and epidemiological changes have prompted thinking on the need to broaden the child health agenda to include care for complex and chronic conditions in the 0-19 years (paediatric) age range. The general and skilled... more
BackgroundDemographic and epidemiological changes have prompted thinking on the need to broaden the child health agenda to include care for complex and chronic conditions in the 0-19 years (paediatric) age range. The general and skilled paediatric workforce shortage especially in low- and middle-income countries (LMICs) will impede the provision of additional paediatric services. This paper examines experiences with task sharing as part of the solution to this human resources challenge in LMICs and specifically looks beyond the provision of care for acute infectious diseases and malnutrition that are widely and historically shifted. MethodsWe (1) reviewed the Global Burden of Diseases study to understand which conditions may need to be prioritised; (2) investigated training opportunities and national policies related to task sharing (current practice) in five purposefully selected African countries (Kenya, Uganda, Tanzania, Malawi and South Africa); and (3) summarised reported exper...
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Background: Mulago National Referral Hospital (MNRH), Uganda’s primary tertiary and teaching hospital, and Makerere University College of Health Sciences (MakCHS) have a close collaborative relationship. MakCHS students complete clinical... more
Background: Mulago National Referral Hospital (MNRH), Uganda’s primary tertiary and teaching hospital, and Makerere University College of Health Sciences (MakCHS) have a close collaborative relationship. MakCHS students complete clinical rotations at MNRH, and MakCHS faculty partner with Mulago staff in clinical care and research. In 2009, as part of a strategic planning process, MakCHS undertook a qualitative study to examine care and service provision at MNRH, identify challenges, gaps, and solutions, and explore how MakCHS could contribute to improving care and service delivery at MNRH. Methods: Key informant interviews (n=23) and focus group discussions (n=7) were conducted with nurses, doctors, administrators, clinical officers and other key stakeholders. Interviews and focus groups were tape recorded and transcribed verbatim, and findings were analyzed through collaborative thematic analysis. Results: Challenges to care and service delivery at MNRH included resource constraint...
Background Demographic and epidemiological changes have prompted thinking on the need to broaden the child health agenda to include care for complex and chronic conditions in the 0–19 years (paediatric) age range. Providing such services... more
Background Demographic and epidemiological changes have prompted thinking on the need to broaden the child health agenda to include care for complex and chronic conditions in the 0–19 years (paediatric) age range. Providing such services will be undermined by general and skilled paediatric workforce shortages especially in low- and middle-income countries (LMICs). In this paper, we aim to understand existing, sanctioned forms of task-sharing to support the delivery of care for more complex and chronic paediatric and child health conditions in LMICs and emerging opportunities for task-sharing. We specifically focus on conditions other than acute infectious diseases and malnutrition that are historically shifted. Methods We (1) reviewed the Global Burden of Diseases study to understand which conditions may need to be prioritized; (2) investigated training opportunities and national policies related to task-sharing (current practice) in five purposefully selected African countries (Ken...
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BACKGROUND With the growing burden of noncommunicable diseases in low- and middle- income countries, the World Health Organization recommended a stepwise approach of surveillance for noncommunicable diseases. This is expensive to conduct... more
BACKGROUND With the growing burden of noncommunicable diseases in low- and middle- income countries, the World Health Organization recommended a stepwise approach of surveillance for noncommunicable diseases. This is expensive to conduct on a frequent basis and using interactive voice response mobile phone surveys has been put forth as an alternative. However, there is limited evidence on how to design and deliver interactive voice response calls that are robust and acceptable to respondents. OBJECTIVE This study aimed to explore user perceptions and experiences of receiving and responding to an interactive voice response call in Uganda in order to adapt and refine the instrument prior to national deployment. METHODS A qualitative study design was used and comprised a locally translated audiorecorded interactive voice response survey delivered in 4 languages to 59 purposively selected participants' mobile phones in 5 survey rounds guided by data saturation. The interactive voice...
Background Many patients with epilepsy in sub-Saharan Africa do not receive adequate treatment. The purpose of the study was to identify the health care providers where patients with epilepsy sought care and what treatment they received.... more
Background Many patients with epilepsy in sub-Saharan Africa do not receive adequate treatment. The purpose of the study was to identify the health care providers where patients with epilepsy sought care and what treatment they received. Methods A cross sectional study was conducted across 87 out of 312 villages in Masindi district. A total of 305 households having patients with epilepsy were surveyed using an interviewer administered questionnaire. Data was entered and analysed in Epi-info ver 7 for univariate and bivariate analysis, and in Stata SE ver 15.0 for multivariable analysis. Sequences of health providers consulted in care seeking, rationale and drugs used, and factors associated with choice of provider were assessed. Results A total of 139 out of 305 (45.6%) households offered some treatment regimen at home when patients got symptoms of epilepsy with 44.6% (62/139) giving herbs and 18.0% (25/139) offering prayers. Eight different types of providers were consulted as firs...
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Research Interests: Mhealth()
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BackgroundAchieving positive treatment outcomes and patient safety are critical goals of the healthcare system. However, this is greatly undermined by near universal health workforce absenteeism, especially in public health facilities of... more
BackgroundAchieving positive treatment outcomes and patient safety are critical goals of the healthcare system. However, this is greatly undermined by near universal health workforce absenteeism, especially in public health facilities of rural Uganda. We investigated the coping adaptations and related consequences of health workforce absenteeism in public and private not-for-profit (PNFP) health facilities of rural Uganda.MethodsAn empirical qualitative study involving case study methodology for sampling and principles of grounded theory for data collection and analysis. Focus groups and in-depth interviews were used to interview a total of 95 healthcare workers (11 supervisors and 84 frontline workers). The NVivo V.10 QSR software package was used for data management.ResultsThere was tolerance of absenteeism in both the public and PNFP sectors, more so for clinicians and managers. Coping strategies varied according to the type of health facility. A majority of the PNFP participants...
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More efforts need to be directed to improving the quality of maternal health in developing countries if we are to keep on track with meeting the fifth millennium development goal. The World Health Organization says developing countries... more
More efforts need to be directed to improving the quality of maternal health in developing countries if we are to keep on track with meeting the fifth millennium development goal. The World Health Organization says developing countries account for over 90% of maternal deaths of which three fifths occur in Sub-Saharan African countries like Uganda. Abortion, obstetric complications such as hemorrhage, dystocia, eclampsia, and sepsis are major causes of maternal deaths here. Good quality Antenatal Care (ANC) provides opportunity to detect and respond to risky maternal conditions. This study assessed quality of ANC services in eastern Uganda with a goal of benchmarking implications for interventions. Data was collected from 15 health facilities in Eastern Uganda to establish capacity of delivering ANC services. Observation checklists were used to assess structural components and completeness of the ANC consultation process among 291 women attending it. Lastly, structured exit-interview...
Research Interests: Program Evaluation, Primary Health Care, Behavior, Quality of Mental Health Care, Developing Countries, and 15 moreHealth, Human Resources, Adolescent, Medicine, Pregnancy, Population, Humans, Female, Patient Satisfaction, Middle Aged, Adult, Cross Sectional Studies, Prenatal Care, Quality of health care, and Pregnancy complications
The objective of this work is to describe the experience of the Uganda Public Health School Without Walls (PHSWOW) in training public health professionals at post-graduate level to offer leadership in planning, delivery of health services... more
The objective of this work is to describe the experience of the Uganda Public Health School Without Walls (PHSWOW) in training public health professionals at post-graduate level to offer leadership in planning, delivery of health services and research within a decentralized health system. As one of the constituents of the Makerere University College of Health Sciences, the Uganda PHSWOW has the vision of becoming a Centre of Excellence, providing leadership in public health and the mission of promoting the attainment of better health of the people in Uganda and beyond through public health training, research and community service. Key to the successes of the program are the 238 program graduates, most of whom have remained in-country to serve at district and national levels of service delivery. Collaborations have been established with government, private, non-governmental and international institutions leading to increased health service provision and research for the improvement o...