Browsing by Author "Nakaggwa, Florence"

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Agony resulting from cultural practices of canine bud extraction among children under five years in selected slums of Makindye:
(BMC Oral health, 2018) Atim, Fiona; Nagaddya, Teddy; Nakaggwa, Florence; Mboowa, Mary Gorrethy N; Kirabira, Peter; Okiria, John Charles
Background: Canine Bud Extraction (CBE) is a process of removing or gouging children’s healthy canine tooth buds embedded underneath the gum using traditional unsterilized tools. The practice of CBE commonly known as false teeth removal continues to be an adopted cultural intervention of choice, in the prevention of morbidity and mortality from common childhood illnesses. However, it is a practice against the rights of children with serious consequences. While CBE is associated with the perceived myth of curative gains, the agony emanating from the cultural practice exposes children to ill-health conditions such as dehydration, malnutrition, blood-borne diseases like HIV/AIDs, septicemia, fever and death. This research sought to understand the factors underpinning the practice of CBE among urban slum dwellers. Method: A cross-sectional study was conducted from five randomly selected slums in Makindye division; 298 household heads or guardians with children below 5 years, who had ever suffered from false teeth were interviewed. The variables measured included guardians’ socio-demographic profiles, determinants of CBE, common childhood illnesses assumed to be treated with CBE and the reported side-effects associated with the practice. Results: Of the 298 respondents with children who had ever suffered from “false teeth” interviewed, 56.7% had two or more children below 5 years and 31.9% were from the central region. The proportion of households practicing CBE was 90.3%; 69.8% of the caretakers mentioned that it was done by traditional healers and for 12.1% by trained health workers (dentists). Number of children (OR = 2.8, 95% CI: 1.1–7.2) and the belief that CBE is bad (OR = 0.1, 95% CI: < 0.001, p < 0.001) had a statistically significant association with CBE. Additionally, number of children (χ2 = 4.9, p = 0.027) and 2 sets of beliefs (CBE treats diarrhea (χ2 = 12.8, p = 0.0017) and CBE treats fever (χ2 = 15.1, p = 0.0005) were independent predictors of CBE practice. A total of 55.7% respondents knew that there were side effects to CBE and 31% mentioned death as one of them. Conclusion: The high proportion of households practicing CBE from this study ought to awaken the perception that the practice is ancient. CBE in this community as the study suggests was strongly driven by myths. The strong belief that CBE is bad provides an opportunity for concerted effort by primary health care providers, policymakers and the community to demystify the myths associated with false teeth and the gains of CBE.
Circumstances of child deaths in Mali and Uganda:
(Elsevier Ltd, 2018-06) Willcox, Merlin L; Kumbakumba, Elias; Diallo, Drissa; Mubangizi, Vincent; Kirabira, Peter; Nakaggwa, Florence; Mutahunga, Birungi; Diakité, Chiaka; Dembélé, Eugene; Traoré, Mamadou; Daou, Pierre; Bamba, Drissa; Traoré, Amadou; Berthé, Diafara; Wooding, Nick; Dinwoodie, Kieran; Capewell, Sarah; Foster, Hamish; Rowena, Neville; Ngonzi, Joseph; Kabakyenga, Jerome; Mant, David; Harnden, Anthony
Background Interventions to reduce child deaths in Africa have often underachieved, causing the Millennium Development Goal targets to be missed. We assessed whether a community enquiry into the circumstances of death could improve intervention effectiveness by identifying local avoidable factors and explaining implementation failures. Methods Deaths of children younger than 5 years were ascertained by community informants in two districts in Mali (762 deaths) and three districts in Uganda (442 deaths) in 2011–15. Deaths were investigated by interviewing parents and health workers. Investigation findings were reviewed by a panel of local health-care workers and community representatives, who formulated recommendations to address avoidable factors and, subsequently, oversaw their implementation. Findings At least one avoidable factor was identified in 97% (95% CI 96–98, 737 of 756) of deaths in children younger than 5 years in Mali and 95% (93–97, 389 of 409) in Uganda. Suboptimal newborn care was a factor in 76% (146 of 194) of neonatal deaths in Mali and 64% (134 of 194) in Uganda. The most frequent avoidable factor in postneonatal deaths was inadequate child protection (mainly child neglect) in Uganda (29%, 63 of 215) and malnutrition in Mali (22%, 124 of 562). 84% (618 of 736 in Mali, 328 of 391 in Uganda) of families had consulted a health-care provider for the fatal illness, but the quality of care was often inadequate. Even in official primary care clinics, danger signs were often missed (43% of cases in Mali [135 of 396], 39% in Uganda [30 of 78]), essential treatment was not given (39% in Mali [154 of 396], 35% in Uganda [27 of 78]), and patients who were seriously ill were not referred to a hospital in time (51% in Mali [202 of 396], 45% in Uganda [35 of 78]). Local recommendations focused on quality of care in health-care facilities and on community issues influencing treatment-seeking behaviour. Interpretation Local investigation and review of circumstances of death of children in sub-Saharan Africa is likely to lead to more effective interventions than simple consideration of the biomedical causes of death. This approach discerned local public health priorities and implementable solutions to address the avoidable factors identified.
Couples’ decision-making on post-partum family planning and antenatal counselling in Uganda: A qualitative study
(Plos One, 2021-05-05) Willcox, Merlin L.; Mubangizi, Vincent; Natukunda, Silvia; Owokuhaisa, Judith; Nahabwe, Haeven; Nakaggwa, Florence; Laughton, Matthew; Chambers, Isabella; Coates, Sabine; King, Emma; Fall, Emma; Muller, Ingrid; Goodhart, Clare; Graffy, Jonathan
Background Although health workers have been trained to provide post-partum family planning (PPFP), uptake remains low in Uganda. An important reason is that women want the agreement of their partner, who is often absent at the time of delivery. In order to address this, we aimed to understand the views of couples and explore barriers and facilitators to implementation of antenatal couples’ counselling on PPFP in Uganda. Methods We conducted individual interviews with a purposive sample of 12 postpartum and 3 antenatal couples; and 34 focus groups with a total of 323 participants (68 adolescent women, 83 women aged 20–49, 79 men, 93 health workers) in four contrasting communities (urban and rural) in South-West and Central Uganda. These were recorded, transcribed, translated, and analysed thematically. Results Although most participants felt that it is important for partners to discuss family planning, half of the couples were unaware of each other’s views on contraception. Most had similar views on motivation to use family planning but not on preferred contraceptive methods. Most liked the idea of antenatal couples’ counselling on PPFP. The main barrier was the reluctance of men to attend antenatal clinics (ANC) in health facilities. Respondents felt that Village Health Teams (VHTs) could provide initial counselling on PPFP in couples’ homes (with telephone support from health workers, if needed) and encourage men to attend ANC. Suggested facilitators for men to attend ANC included health workers being more welcoming, holding ANC clinics at weekends and “outreach” clinics (in rural villages far from health facilities). Conclusion Antenatal couples’ counselling has the potential to facilitate agreement PPFP, but some men are reluctant to attend antenatal clinics. Counselling at home by VHTs as well as simple changes to the organisation of antenatal clinics, could make it possible to deliver antenatal couples’ counselling on PPFP.
A Cross Sectional Study of the Knowledge, Attitudes and Practices Regarding Utilization of Modern Contraception Among Women and Men of Namuwongo.
(International Health Sciences University, 2011-09) Nakaggwa, Florence
The United Nations Population Fund (UNFPA) estimates that the world´s population will be 8 billion in 2050. This increase is attributed to the high population growth rate which is influenced by the world´s total fertility rate and contraceptive prevalence rate (CPR). UNFPA has embarked on a drive to increase CPR particularly in developing nations with a focus on modern contraceptive methods, with the hope that this will contribute to a reduction in the overall world population. Uganda´s theme for this year was ¨Uganda at 33 million; Time to Act¨. With an annual population growth rate of 3.3% and a total fertility rate of 6.1, the country needs to increase efforts towards use of modern contraception. This is because there is a high population of unproductive youth in the reproductive age group who are migrating into urban slums where health services and living conditions are inadequate. The purpose of this study was to identify the knowledge, attitude and practices regarding the use of modern contraception among the men and women of Namuwongo slum. Methodology: A cross-sectional study of 282 respondents between the age 15-49 (for the women) participated in the study. Residents who were mentally challenged, and female residents who did not lie in the age range were excluded. Standardized pre-coded and structured questionnaires were used to obtain information from the respondents. The independent variable was use of modern contraception while the dependent variables were knowledge, attitude and practices regarding modern contraceptive use. Results: 193 were females, while 89 were male. 51.1% were youth in the age range 15-24 years. 40.8% of the respondents were unemployed and 63.8% were married. 39.7% of respondents admitted to using contraception. 11.9% of those who said that they were not using contraception, however, they admitted to using condoms which implied that they did not recognize condom use as a method of contraception. This raises the CPR to 46.8%. Nonetheless, 13.5% were contemplating discontinuing use of modern FP because of side effects. The commonest methods were condoms and injections. Knowledge of methods was 78.7%. At p<0.05, knowledge, spousal communication, and final decision making was statistically significant. 60.3% of respondents were not using a modern method of contraception. Side effects constituted 52.1% of perceived obstacles to use of modern contraception. Conclusion: Knowledge of contraception was relatively high, however, CPR is low for a community that has such a high population of youth that are unemployed. The major hindrance which is side effects needs to be addressed to dispel myths surrounding modern FP use. The role of men in influencing modern FP use is important because they are the ones with limited knowledge on FP yet they take part in decision making about the matter.