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Acceptability of Modern Contraceptive Methods by Manyata Leaders in Napak District, Karamoja Region.
(International Health Sciences University., 2015-12) Lodim, Joshua.
Uganda is classified as one of the 49 poorest countries, and its population growth is one of the highest in the world, at 3.4 percent. In 2011, the population was estimated to be 34.5 million, and the bottom of the population pyramid is also getting larger. Uganda has the second youngest population in the world (Wulf D, et al., 2006). Nearly 52 percent of its inhabitants are under the age of 15, and 78 percent are under 30 years of age. The age group 15-24 years is estimated to constitute 20 percent of the population. Contraceptive use in Uganda remains low with an unmet need of 36% among all women of reproductive age. The purpose of this study was to determine acceptability of modern contraceptive methods among Manyata leaders in Napak district in Karamoja region. The study was a descriptive cross-sectional study involving a sample size of 154 Manyata leaders in Napak district. Data was collected using a semi-structured questionnaire for quantitative data and a focus group discussion for qualitative data. Simple random sampling was used to select the Manyata leaders to participate in the study. The results of the study indicated a low level of acceptability of modern contraceptive methods at 18% among the Manyata leaders. The modern contraceptive methods accepted by the Manyata leaders were pills, intrauterine devices, condoms and implants. The reasons for accepting the use of modern contraceptive methods were to prevent unintended pregnancies within the community, proper family planning, to avoid sexually transmitted diseases, child spacing and when there was no need for more children. The reasons for not accepting the use of modern contraceptive methods were cultural influence where culture did not support the use of contraceptive methods, the need for many children among community members, lack of knowledge about the use of contraceptives, negative peer influence and perceived dangers of using modern contraceptives such as infertility. The demographic factors that were found to significantly influence the acceptability of modern contraceptive methods were age and income levels of the Manyata leaders. Average aged Manyata leaders (X2=9.672, p=0.010) and those with higher income levels (X2=6.521, p=0.024) had more acceptability for modern contraceptive methods as compared to their older colleagues and those with low incomes. Therefore, the government through the ministry of health should conduct community sensitization among the Manyata leaders on the importance of using contraceptive methods in family planning and having small manageable families. This will remove wrong beliefs about contraceptives as well as increase uptake of such methods among the community. Awareness campaigns on the use of modern contraceptive methods should be done through the use of mass media, by the government and other development partners so as to create awareness among the communities on the use of contraceptives.
Accessibility and Utilization of Informal, Communication Technology (ICT), in Students Learning Processes:
(International Health Sciences University, 2013-09) Ssesanga, Dennis Ernest
The purpose of this study was to establish the accessibility and utilisation of Information Communication Technology in learning processes among students at IHSU. The study had four study objectives namely; find out the accessibility level of ICT to students, determine the level of students‘ knowledge on the usage of ICT, examine the attitude of students and lastly determine the practices of students on the utilisation of ICT in the learning process. A cross sectional study design was utilized in carrying out data collection procedures in October 2013 at International Health Sciences University. The design was preferred as it facilitated the obtaining of diverse information about the accessibility and utilisation of ICT in the learning processes during this point in time. The study employed both qualitative and quantitative data collection approaches. The university has a population of 1500 students all doing different courses and on different academic programmes namely; full time, part time and remote learning. A sample size of 316 university students undertaking undergraduate courses was selected to take part in this study. It was carried out in all the university institutes namely; health policy and management, nursing science and allied health services. The data was obtained from three sources namely; students, two key informant interviews of the head of library and ICT departments, and lastly interviewer observations using four different tools and instruments namely; key informant interview guide, an observational check list, digital camera and an online questionnaire. Data was collected, checked, coded; entered using Google forms then processed using Google analytics obtained online to generate bar graphs, pie charts and tables. All the questionnaires were systematically analysed on submission. From the findings, most of the students (50%) got first exposure to the use of ICT in learning at university. Students may have a better learning process if the ICTs are well embraced both at home work and university. From the above findings, 96% of the sample population which was the majority accesses ICT at the university while 28% access at the place of residence, 20% at an internet cafe and 16% through a friend‘s computer. Seventy seven percent of the sample population which was the majority accesses ICT at the university while eight percent access at the place of residence, six percent at an internet cafe and five percent through a friend‘s computer. The majority 282 students were unaware about advanced searching techniques while the second problem of the sample population was with formulating a search query or keywords, while 235 students lacked knowledge about open access journals and 233 students lacked knowledge about browsing e-journals. According to the results above, 48% of the students agreed that the learning process will not be effective without use of ICT tools and techniques and 25% of the disagreed. According to the results above, 48% of the students agreed that the learning process would not be effective without use of ICT tools and techniques and 25% of the disagreed. 36% of the students agreed to having used turnitin sometimes while 32% said they always use it and the other 32% had never used it. 38% of the students had never used online journals while 37% of the students used them sometimes and 25% of them were found to use them always. 55% of the students had never been recommended by the lecturers to use online journals while 43% reported that their lecturers sometimes did recommend and only 3% were always recommended. 91% of the students reported that they never used turnitin for their class work assignments while 8% sometimes did and only 1% always used it. The following were the accessibility possibilities of ICT available to students in their learning processes; students need to be assisted in attaining devices that will increase their utilisation of ICT both away and at the university. In regard to the level of students‘ knowledge on the usage of ICT in their learning processes; there is need to teach students about the various computer applications that are being used at school for their academic performance. Considering the attitude of students on the utilisation of ICT in their learning processes; there is. Students need to be enlightened about how will be effective with the use of ICT tools and techniques and this should be done with the involvement of the lecturers so as to improve the attitude of students about the need of ICTs in the leaning processes. Lastly, with respect to the practices of students in the utilisation of ICT in their learning processes; there is need to improve the use of turnitin and online journals in class assignments amongst the students. Generally all students should embrace the fact that ICT has come and should be highly welcomed in all fields of learning because it is what has enabled the first world to develop and be in the lead of all the other countries. Looking at how many students had moderate scores, on all the variables especially for accessibility, knowledge, attitudes and practices, there is a possibility that in the next ten years, the majority of students will have serious ICT limitations in the learning process and at work if no precautions are undertaken by those in authority.
Actors influencing alcohol abuse among out-of-school youth in Mbale municipality, Mbale district.
(International Health Sciences University., 2015-12) Wobbaka, Faith Joyce.
The study was to determine factors influencing alcohol abuse among out-of-school youth in Mbale Municipality Mbale District. General objective: was to investigate factors influencing alcohol abuse among out-of-school youths in Mbale Municipality. The specific objectives were: to determine individual factors influencing alcohol abuse among out-of-school youths, to identify socio-economic factors influencing alcohol abuse among out-of-school youths and to establish cultural factors influencing alcohol abuse among out-of- school youths in Mbale Municipality. Methodology: A descriptive cross-sectional study design was used for the study in which 248 respondents consented before being interviewed; both qualitative and quantitative methods of data collection were used through key informant interview guide and questionnaires respectively to obtain information concerning the above stated study. Data was analyzed in SPSS and the results presented in tables, pie charts and graphs. Results: The findings indicate that the major factors influencing alcohol abuse among out of school youths in Mbale Municipality included the following variables, in order of their significance: Staying with parents who drank alcohol (P-value=0.000), Involvement of youth in Cultural rituals as marriage, circumcision and last funeral rite which require the use of alcohol(P-value=0.000),Employment status(P-value=0.011) ),Heard of adverts for alcohol(p<0.017), Gender (P-value=0.027), Age at which the youth starts to drinking alcohol (P-value=0.031), Place of residence (P-value 0.041) and Cultural perception on the consumption of alcohol among the youth(P-value=0.047) showed statistically significant association with the consumption of alcohol among out-of school youths. Other individual factors such as age, marital status, religion and staying with parents, level of education, average monthly income, role models and existence of community policies on the consumption of alcohol among the youth did not indicate a statistically significant association (p>0.05) with the consumption of alcohol. Conclusions: The key significant factors influencing alcohol abuse among the youths in Mbale Municipality included the following gender, place of residence, staying with parents who drink xiv alcohol, age at which the youth start drinking alcohol, employment status, heard of adverts for alcohol, cultural perception on the consumption of alcohol among the youth and involvement of youth in cultural rituals which require the use of alcohol. Recommendation: Government through Ministry of Education should strengthen educational programmes by encouraging schools to come up with attractive programmes including but not limited to crafts and handiwork or vocational trainings and maintain the youths in schools, in addition give scholarships and students loan. And impose and implement high taxes on alcohol both locally made and imported to lessen easy access for the youth. District to setup strong community policies that regulate drinking alcohol in public places; such as opening drinking places after 5:00pm closing at10;00pm on working days and opening at 2:00pm on weekend and closing at midnight and prohibit sale of alcohol before the stated time. The District authorities should arrest sellers especially those who sell alcohol to youths below 18 years of age. The District Authorities together with the Local Council leaders to restrict the use of alcohol in homes especially by adults who might influence children to use alcohol for example alcohol at home may only be allowed during special occasions. Future studies should be done on factors influencing alcohol abuse among in school youth in Mbale Municipality.
Actual and Preferred Birth Intervals of Mothers Attending Antenatal Care at Mbale Regional Hospital.
(International Health Sciences University, 2013-09) Muhenje, Sophie Mukoone
Background; Population growth is a major challenge in most developing countries, and Uganda is no exception to this. In Uganda, the rate of population growth is 3.2% (UBOS, 2012), which can be attributed partly to an imbalance between infant mortality and fertility. Short birth intervals are associated with an increased risk of adverse health outcomes, including infant, child and maternal mortality. Short birth intervals (< 2 years) can lead to maternal depletion syndrome, milk diminution and competition between siblings close in age for food and other resources. Objective; The objective of this study was to assess the actual and preferred birth intervals of the women in Mbale regional referral hospital. Methods; This study adopted a cross-sectional study design. This design was chosen because it could collect data to make inferences about a population of interest (women attending ANC) at one point in time. The study population included women who were attending both antenatal clinics and post natal clinics in outpatient departments who had had at least two children prior to the current pregnancy or had already two children respectively. Data was collected from the women using a variety of methods including interviews and tools. Results; Socio economic factors such as education of the mother/husband, occupation of the mother, transport costs to the hospital, paying some extra fee (bribe) to health workers before getting the service, afford-ability of services offered by the health centers, whose decision to have the current pregnancy, cultural influence to have shorter or long birth intervals, showed a statistical significance with actual and preferred birth intervals with p values 0.000 (p<0.05). Socio demographic factors like residence, age of mother, and age at first pregnancy were found to be significantly related to the birth spacing where as for community factors, breast feeding of the previous last child, duration of breast feeding, whether they exclusively breastfed their children, community perception on the use of family planning methods and community preferences on the gender of children to birth to showed a statistical significance with actual and preferred birth intervals. Conclusion; Socio economic and demographic factors of the women play a major role in determining birth intervals. Recommendations; Policy makers need to consider the potential for lengthening birth intervals in Uganda where the median birth interval is close to 3 years (2.88 years). Data from other African countries suggests that even in situations when women wish to increase spacing it is by no more than six months (Rafalimanana and Westoff, 2001). It has been found that women who are educated tend to have longer birth intervals, therefore girl child education should be further boosted to increase their literacy rates.
Adequacy and Utilization of Sanitation Facilities in Primary Schools in Masaba North District, Kenya.
(International Health Sciences University, 2013-09) Misati, Moraa Edinah
The currently high and ever- increasing enrollment in schools since 2003 in Kenya, as a result of the Universal Primary Education has made water, sanitation and hygiene issues of national significance. The available sanitation facilities cannot adequately serve the school children. The objective of this study was to assess the adequacy and utilization of sanitation facilities in primary schools in Masaba North District. A descriptive cross-sectional study was used. Data was collected using self-administered questionnaires, key informant interview and observation checklist. A total of 340 participants sampled by simple random procedure and purposive sampling fulfilled the study criteria and were included in the analysis. Although there was a good availability of pit latrines (89.2%) and urinals (71.3%), as well as rubbish pits (70.9%) in the sampled schools, and that of hand washing facilities such as taps and soap (58.1% and 18.4%). Generally the hand washing facilities were unavailable in the selected primary schools. Developing sanitation programs under which the challenges should be tackled right from the root rather than attempting to manage the resultant unpleasant consequences, proper planning for the schools‟ carrying capacity, and including suitable sanitation and hygiene strategies in the curriculum of teachers training institutions, are critical for the country to improve its hygiene and sanitation in schools.
Adherence and Associated Factors to Intergrated Management of Malaria Guidelines in Lake Shore Facilities in the Districts of Buyende and Kaliro, Uganda
(International Health Sciences University., 2016-11) Kaula, Henry
Background: Malaria is a life-threatening disease. In Uganda, the Ministry of Health adopted the artemisinin combination therapy (ACT) artemether/lumefantrine (AL) 20mg/120mg as the first-line treatment for uncomplicated malaria in 2004(MoH, 2012). Further, Uganda also adopted the WHO (2012) guidelines of testing all suspected cases of malaria prior to treatment (MoH, 2012). It’s unclear whether health care providers in these districts adhere to the Ministry of Health (2012) guidelines for malaria management. Objectives of the study: The objective of this study was to assess level of adherence and associated factors to national malaria management guidelines by health providers in lake shore areas in Uganda. Methods: A cross sectional study design used and data was collected from patients and providers from selected health facilities. A total of 286 patients were screened and 197 were eligible and consented to participate in the study. A total of 26 health care providers were interviewed. Results: Appropriate medical history taking and physical examination was only reported by 8.1% of the patients, 65.5% were tested either using Rapid Diagnostic Testing kits (RDTs) or microscopy. Only 6.1% reported adherence to appropriate medical history & appropriate physical examination and testing for malaria. Regarding adherence to prescription guidelines, 18.6% of those who tested negative received an ACT drug/prescription, and 10.1% tested positive but did not receive an ACT drug or prescription. Overall adherence to all guidelines (medical history, physical examination, testing, and prescription) was a mere 3.1% and health care provider training on the guidelines was the only factor associated with adherence. Conclusion and recommendations: The overall level of adherence to the national malaria management guidelines was very low with only 3.1% of the patients managed in strict adherence to the national malaria management guidelines by the health care providers. This calls for health care provider trainings on malaria management to improve adherence.
Adherence of health workers to the integrated child health care management protocols:
(International Health Sciences University, 2012-09) Vunni Draiko, Christopher
ABSTRACT Introduction: Following the adoption of IECHC in Republic of South Sudan, many counties including Magwi started implementing the guidelines. However, there is no evidence that health workers adhere to the recommended IECHC guidelines in Magwi County in Republic of South Sudan. Objective: The main objective of the study was to assess the adherence of health workers to the integrated Essential Child Health Care guidelines for assessing and managing children from 2 months to 5years of age. Methodology: A cross sectional descriptive study was conducted at 49 government and private health facilities in Magwi County. Data was collected through observation of health workers by using checklists on their encounter with sick children and carrying out key informant interviews and Focus Group Discussions with the health workers in all the 49 health facilities in Magwi County in Republic of South Sudan. An observational checklist modified from the multi Country Evaluation tool for IMCI developed by the WHO/UNICEF was used during the study. The study was conducted between the months of mid July and mid September 2012. All the health workers working in Magwi County and were present at the time of visit were observed. All the One hundred Ninety Seven (197) health workers in Magwi County were interviewed and also observed examining a total of 334 sick children. The quantitative data was analyzed using SPSS soft ware and the data presented in form of tables, graphs and charts while the qualitative data was manually analyzed and presented in verbatim and phrases. Results: Most of the health workers managing children were community health workers (CHW) 49.2%. (Chi square 19.062, df1, P<0.00) Only 25% of the health workers checked or classified for general danger signs. The health workers had deficiencies in assessing and classifying anemia and malnutrition and most of the classifications for the main symptoms were incorrect. The health workers prescribed correctly the needed drugs for malaria ;( Chi square 72.17, df 1, P<0.00) however, antibiotics were unnecessarily given in other conditions when not needed. 49.2% of the health workers checked for immunization status, 44.1% checked for vaccination card, polio vaccines BCG and vaccines respectively. Only 30% of the health workers administer or send the sick child for immunization during the day of observations. The result has shown some adherence to IECHC guidelines on counseling of caretaker on home treatment as 86% of the health workers explained to the caretakers how to administer oral antibiotics, 96.5% explained on anti malarial drug, 66% of health workers explained how to give ORS and 66% of Zinc respectively. However there was non - adherence of health workers to the guidelines on showing the caretaker how to administer the oral medications at home and asking questions to understand the caretaker. The study indicated that only 25% of the health workers used the IECHC chart book during their consultations. Majority 75% of the IECHC health workers did not used the chart booklets. Therefore the study found out that there is non- adherence to the use of the guideline. On treatment of the various classifications by the health workers, majority (85%) of the health worker adhered to treating malaria. Many of the health workers treated both incorrect and correct classification. Further The study also found out that health workers prescribed antibiotic medication to the sick children, some of this antibiotic were not warranted and could be based on the essential list of not on the IECHC guidelines. There adherence to counseling of the caretaker on home treatment by health worker was poor; The result indicated that only 39.4% health workers counsel the mother on giving fluids and continued breastfeeding , 27% on how to administer treatment at home , 22% counsel the caretakers on when to return immediately. Furthermore 72.1% of the health did not assessed for child’s feedings, 75.2% did not assed or asked if the child feeding had changed and 66.5% never ask about fluid and other feeds. This is clear indication of non adherence to the implementation of IECHC guideline. The study found out that majority of the health facilities had essential drugs for the IECHC essential oral drugs during the observational period. However over 75% of the facilities do not have inject able IECHC care drugs as pre referral treatment and for those children who cannot take oral treatment. There has been marked improvement in the health systems and essential drug for IECHC although despite 50.6% of the health facilities were not having functional fridge and available vaccines for immunization Conclusion/Recommendations: The study found out that the adherence of heath workers to the IECHC guidelines in Magwi County poor. However due to the introduction of IECHC, there has been substantial improvement in the health systems factors like drugs and capacity of health facilities especially equipments.
Adherence to Food Safety Culture in Retail Food Establishments:
(International Health Sciences University., 2014-11) Ndahura, Vastinah
Adherence to Infection control measures Among Heath workers in Private Health Centres in Kampala district.
(International Health Sciences University., 2015-12) Christine, Namutebi
Introduction The research was about adherence to infection control measures among health workers in private health centres in Kampala district. Infection control was the area of interest as it is still not given too much attention in the developing countries yet causes one of the most unnoticed risk to lives of health workers as well as the clients and their care takers. The research objective was majorly to assess the level of adherence to infection control measures among health workers in private health centres in Kampala district. Method The sample size was calculated using the Kish and Leslie formula from which 185 respondents were to participate in the study. A questionnaire with both open-ended and closed questions was then filled by the select respondents who were randomly selected from the general cluster of health workers in private health centres in Kampala district. Data collected were entered using Epi-data and analyzed using the Statistical Package for Social Scientists; version 20. Binomial and bivariate tests were run with the level of significance of 5% that is p = 0.05. Results From the analysis, the level of adherence to administrative infection control measures was the highest at 81.19%. Level of adherence to environmental infection control measures was 66.85% while that for adherence to infection to personal protective infection control measures was the lowest at 60.40%. Of the factors that affected adherence to infection control measures, job satisfaction, good work environment communication and on-job CME were the most significant with a p-value of 0.000. Having attended training on infection control measures was significant as well (p =0.003). In addition to that, staff supervision and facilities having copies of infection control guidelines were the most insignificant with a p –value of 0.659. Analysis of the descriptive factors presented minimum number of health-care staff at a given facility as the factor that would affect the average number of clients attended to within a given period of time. These two were strongly positively correlated. Conclusions Health-care Associated Infection is one of the least catered for risks in health-care service delivery, most especially in the under developed countries, though a potentially preventable adverse event than an unpredictable condition. The connotation of this is it is always prevailing and can occur in any health-care setting. This calls for prompt compliance to all the infection control measures. Prompt compliance to infection control measures would not only avert association with host barrier, but transmission between and amongst individual (health-care staff, clients and care takers at the facility) as a whole. Recommendations Some of the suggested ways to increase adherence to infection control measures among the health workers in private health centres were facility heads being taught the benefit of credit saving societies amongst themselves for increased financial base, periodic survey of these health centres fo compliance, sensitization of populations about the necessities towards infection control while visiting the health centres and health workers embracing Continuing Medical Education to conquer evolution of ill-health disease causing organisms.
Adherence to Infection Control Practices Among Barbers in Kampala Capital City 2012.
(International Health Sciences University, 2012-09) Ssekaboga, David
Introduction There is a big concern that barbering procedures could expose both barbers and their clients to various infections. These infectious diseases and conditions that can be spread through barbering procedures include; skin diseases like dermatitis, fungal infections, and viral infections like HIV, Hepatitis B, and Hepatitis C among others. However, little is known about adherence to infection control among barbers in Kampala City. Objectives The main objective of this study therefore was to establish adherence to infection control practices among Barbers in Kampala Capital City. The study was particularly interested in establishing the availability and safety level of equipment used by barbers, determining the barber factors as regards infection control and establishing the implementation of barbering policy issues by different regulatory bodies. Methodology This was a cross sectional study that utilized both qualitative and quantitative methods of data collection. A hundred and eight barbershops were involved in the study; one barber from each of the barbershops was interviewed and observed. The barbershops were selected using systematic random sampling while the barbers within the barbershop were selected using simple random sampling. An observation checklist, questionnaire and key informant guide were used to collect data. Quantitative data entry and analysis was done using SPSS version 3.5.1 and Microsoft Excel 2010 software. Qualitative data was analysed using the thematic approach. Results All the barbers that were interviewed were males. The findings of this study revealed that most barbershops did not have sterilizers (55.5% of all barbershops) while only 40% of all sterilizers were found to be functional. There was a significant association between the education level of the barbers and the level of safety of equipments used in the barbershop. (X2 =12.469, P= <0.014), with the barbers with a high education level being more likely to have equipments processed to a higher safety level compared to their counterparts with low education level. Most of the barbers (69.4%) do not examine the clients’ head for infections prior to shaving and majority (91.7%) admitted that they just continue with the shaving process when they identify infections on the clients’ scalps. The utilization of PPE was low; gloves and aprons were found to be used by very few barbers that is; 9.3% and 23.1% of all the barbers respectively. Apron use was more common among barbers with high equipment safety level (X2=10.082, p= 0.003). as compared to those in the category of low equipment safety level. Only in 18% of all barbershops that were involved in the study had hand washing done yet 91.7% of all barbershops that were involved in the study had water available. While only 8.3% of all the barbers washed their hands with soap before beginning shaving. The key informants from UNBS stated that their role was only to set up standards for KCCA public Health Department to enforce, however, key informants from KCCA attributed their lack of regulation of barbers to low facilitation of the department and the general low priority given to environmental health activities in the authority. Conclusion The study found that barbers in Kampala City generally do not adhere to infection control practices exposing themselves as well as their clients to various infections. It was discovered that majority of the barbers did not sterilize let alone disinfect shaving equipment with potent disinfectants between clients. The Local Authority was not active in regulating the establishment and operation of barbershops and inspecting the premises to assess their suitability for the purpose.
Adherence to Infection Control Practices in Hospital Wards in Makindye Division, Kampala District.
(International Health Sciences University., 2013-09) Jane, Mugga Settuba
Introduction: Patients seek health care from hospitals because of various illnesses in order to live healthy lives. It is therefore the responsibility of the hospital to ensure that the patients get proper treatment while in hospital and to prevent any further infection while in the hospital setting. This is done by observing standard infection control practices in the hospitals However, adherence to affection control practices in hospital wards has not been given the attention it deserves in terms of regulating it and guiding all the hospital staff to adhere to it. This in the end has had a negative health impact of registering hospital related infections. Objective To determine adherence to infection control practices and factors affecting adherence to infection control practices in hospitals in Makindye division. Methods A descriptive cross sectional study employing both qualitative and quantitative methods of data collection was used. The study was carried out in four hospitals in Makindye division, Kampala district. Our calculated sample size using the Kish and Leslie formula was 246 respondents who were interviewed using self administered questionnaires. Twenty one observation checklists were administered in the 21 hospital departments/wards. Data was analyzed using SPSS and Epinfo Version 3.3.2 (2005) and Stata 8.2 soft ware and analysis was done in stages involving uni-variate, bivariate and multivariate analysis. Data is presented in tables, graph and chart. Results The study showed that much as the health workers were knowledgeable about infection control, 96.3% revealed it was not practiced in the hospitals were they worked. Lack of equipments to use, lack of knowledge regarding infection control practices and lack of commitment of the administrators to make supervision on infection control practice were reasons given for non adherence in the hospitals. 65% of the hospital staffs ranked the level of adherence to infection control in hospitals as low; 95.1% of the hospital staff members reported hospital acquired infections in the past two weeks, with tetanus as the most hospital acquired infection. 90.5% of the respondents had been trained in infection control practices, 55.4% from medical schools. 91.4% were in the know of at least hand washing, proper waste disposal, use of protective equipments and prevention of needle stick injuries as “specific infection control practices”. 47.9% had received the three vaccinations that is; Hepatitis, Tetanus and TB. 89.4% knew at least three situations in which they wash hands routinely with soap as “after contact with individual patients or their immediate environment” or “ before manipulating medical devices” and “after using bathrooms, toilets and latrines; 88.6% were always washing hands, 84.9% knew that hospitals had infection control guidlines,77.2% knew about the infection control guidelines as laid down by the ministry of health; 81.6% were taking action as “immediately stopping working the moment they had got needle stick injuries”.78% were putting on gloves with 93.5% washing hands after removal of gloves. 84.5% were washing hands between patients being examined. 60.8% of the health workers were wearing protective equipments always like gloves, goggles, aprons and masks. From the check lists, all hospitals had hand washing facilities. 71.4% had a hygiene policy and 42.8% were available but not displayed. 61.9% showed that the wards did not have visible swabs that were dirty, stained or wet, 81% of the wards had puncture proof disposal boxes for disposing of used needles and injection in treatment and 81% had properly well labeled waste disposal bins on the wards, 90.5% of the health workers were putting on protective equipments,61.9% showed that hospitals were disinfecting patients rooms after patient discharge, The study further revealed at 57.1% that soap was not available at hand wash facility. 71.4% of the available boxes or bins were over flowing, open and pierced, almost all people handling waste were not putting on protective wear. 52.4% did not have cleaning schedule for patients’ rooms. Of those who had cleaning schedules, 47.6% were cleaning once a day, 85.7% hospitals were changing linen only when soiled. At bivariate analysis, the staff’s training in infection control measures was associated with the level of adherence to infection control with a chi square value of 4.17 and a P-value of 0.001. Hospitals whose staff members had been trained in infection control were 1.68 times more likely to have high level of adherence to infection control as compared to those hospitals whose staff members had no training at all in infection control. The staffs’ knowledge about whether the hospital has an infection control guide was a significant factor in explaining the level of adherence to infection control with a chi square value of 5.491 and a P-value of 0.004. Hospitals whose staff members were knowledgeable about infection control guidelines/policy were 12.3 times more likely to adhere to infection control measures as compared to those hospitals whose staff members were ignorant of the guide/policy. The hospital staffs knowledge about the infection control guide as laid down by the ministry of health in Uganda, had a chi-square value of 9.065 and a P-value of 0.0011. This means that hospital which had hospital staff members ignorant of the infection control guides as laid down by Ministry of health Uganda, these hospitals were 0.379 times less likely to adhere to infection control practices as compared to those hospitals whose staff members were knowledgeable about the guide lines as laid down by Ministry of Health. The hospitals with equipments available are 12.3 times were more likely to adhere to infection control practices as compared to hospital with limited equipments is obtained at a chi square value of 8.275 and a P-value of < 0.000. The knowledge of the health workers about the hospital policy of waste management and disposal was significantly associated with the level of adherence levels to infection control practices at a chi square value of 15.921 and a P-value of 0.000. Administrative commitment on infection control practices was significant at the chi square value of 9.28 and a P-value of 0.0008. Hospitals in which the patient –health worker ratio was high were 0.25times less likely to adhere to infection control measures as compared to those with a low patient health worker ratio. This was at a chi square value of 4.296 and a P- value of 0.0005. After adjusting for confounding at the multivariate level using log likelihood ratio, all the variables ended up being significant and these variables were; Staff levels of training (OR = 2.19, 95%CI 1.70-2.492, P-value 0.000); Staff’s knowledge about infection control guides as laid down by MOH (OR= 0.34, 95 % CI -0.86-0.5, P-value 0.0016); Staff’s knowledge about hospital infection control guidelines / policy (OR=2.58, 95%CI 1.63-3.79, P-value 0.0010); Staff’s knowledge about hospital waste management policy (OR=0.36, 95%CI 0-0.023-0.58, P-value 0.0090) ; Lack of equipment (OR= 3.46, 95%CI 0.41-4.67, P-value 0.021); Staffing; that is; Patient - staff load (OR=4.24, 95%CI 2.46-8.64, P-value 0.032); Administrative commitment/ infection control supervision by infection control personnel (OR= 2.45, 95%CI=1.04-2.967, P-value 0.0013) Conclusion and recommendations Continuous on job training in infection control Displaying of the recommended infection control practices within the hospitals in areas that are accessed by all staff and patients on the hospital ward, Proper allocation of materials as required; A reward systems for those identified as adherence to infection control in the hospital wards. The recommendations above will facilitate adherence to infection control practices in the hospital wards. A clear system concerning supervision of hospital wards by infection control personnel should be laid out.
Adherence to Intermittent Preventive Treatment for Malaria Among Pregnant Women in Mawokota South Health Sub-District, Mpigi District.
(International Health Sciences University, 2012-09) Nuwagaba, Denis
Introduction While the Ministry of Health since 1998 embraced Intermittent Preventive Treatment (IPT) strategy, its utilization has remained low in Uganda fluctuating between 42% and 39.6% against Health Sector Strategic Plan (HSSP) II target of 80%. In Mpigi District and Mawokota South HSD the study site utilization of IPT was estimated at 35% lower than the national coverage. The main objective of the study was to investigate factors influencing IPT utilization for malaria among pregnant women in Mawokota South Health Sub-District-Mpigi District. The specific objectives of the study were: To determine community knowledge and perceptions about IPT and level of utilization; To determine the relationship between social demographic factors of pregnant women and utilization of IPT; To determine the relationship between the economic status of pregnant women and utilization of IPT; To describe health facility related factors affecting IPT utilization. Methodology: A cross-sectional descriptive study design was adopted and both quantitative and qualitative data collection methods were used. Data was collected from 99 respondents and these included; 68 pregnant women receiving ANC services at four health facilities, 23 women participated in focus group discussions, the key informants included; 5 In-Charges of ANC clinics/maternity wards at the selected four health facilities, and 3 village health team members/community resource person. Results: The study found out that majority of pregnant women attending ANC clinics (86%) and those in FGDs had heard about IPT. Although IPT service was generally well perceived in the community with 20.6% of mothers attending ANC clinics rating it as excellent and the majority (66.7%) rating it as good, this did not translate into its timely utilization. Out of 57 pregnant mothers attending ANC clinics, only 24.6% can be categorized as good IPT utilization practice compared to a majority 75.4% which represent poor IPT utilization practice. Like earlier studies, background characteristics of respondents were found to impact on IPT utilization. The study found that younger pregnant women (16-25 years) had a good IPT utilization practice estimated at 14% compared to 8.8% for older women (26-35 years). A mix of service delivery factors such as rudeness of health workers, costs involved to obtain IPT, limitations at health facilities in delivery of IPT and gaps in information about IPT by health workers plus community barriers such as poor perceptions and limited access contributed to low utilization of IPT. These findings imply that if factors contributing to low utilization of IPT are not addressed, Uganda is not likely to meet MDG goal of reducing the unacceptably high maternal mortality rate (435 deaths per 100,000 live births). Malaria is a major cause of illness and death among pregnant women. Recommendations: The study recommends that government should build on the good DOTs for IPT strategy to bridge the information gaps and overcome unfounded community fears by refreshing health workers’ knowledge and skills and intensifying community awareness and their involvement in IPT service delivery. This is expected to enhance utilization and contribute to the realization of set IPT targets. It is also recommended that further research be carried out about the influence of social economic factors on utilization of IPT. Research should also be conducted about the extent to which the fear of taking HIV test as part of ANC has affected IPT uptake and utilization.
Adherence to Iron-Folic Acid Supplementation and Associated Factors:
(International Health Sciences University., 2016-11) Ndungutse, Amos; Hashaka
Introduction: Adherence to iron folic acid supplementation is a very important issue in combating iron deficiency anemia. Yet there are many factors ranging from individual, socio-economic and health facility related that contribute to this low adherence. This study focused on the adherence among pregnant women in second trimester at Gulu regional referral hospital in northern Uganda. Objective: To establish the proportion of adherence to iron- folic acid supplementation and the associated factors among pregnant women attending Antenatal at Gulu regional hospital-northern Uganda Methods: A cross sectional study design employing quantitative and qualitative approaches were used to determine level of adherence to iron folic acid supplements and factors associated among pregnant women attending antenatal care at Gulu regional hospital. A sample of 402 pregnant women in their second trimester and two key informants were selected through purposive sampling method to be interviewed. Results: The results shows that proportion of adherence was 63.7% and the factors which were significantly associated with it included number of children (p-value of 0.000) number of times the mother was taking (p-value of 0.003), number of months (p-value of 0.033, willingness to continue taking (p-value of 0.000); knowledge on the how many iron folic acid supplement Knowledge on the importance and how to manage side effects after taking iron folic acid supplements (p-value of 0.000) having seen posters on iron folic acid supplements. Conclusion: The proportion of adherence was high among pregnant women at Gulu regional referral hospital and the factors such as number of children, number of weeks, number of months and knowledge of the women on importance and management of side effects were significantly associated with high levels of adherence. Recommendations: Pregnant women should report early for antenatal services so that the health workers can be able to provide to them all the components of goal oriented ANC Pregnant women should use other available sources of information about iron folic acid supplementation not only the radio but through peer to peer groups and the mother in laws who have experience in child upbringing.
Adherence to Laboratory Quality Management Practices:
(2014-11) Nyanda, John Bosco
The study titled: Adherence to Laboratory Quality Management Systems (LQMS) in Private Not For Profit (PNFP) laboratories in Kampala District, was conducted at the four (4) PNFP facilities of Nsambya, Kibuli, Lubaga and Mengo hospitals in Kampala. The main objective: The study was set out to assess the level of adherence to LQMS practices in PNFP hospital labs in Kampala. Specifically to: Assess the process factors influencing adherence to practice of LQMS, assess the human resource factors influencing adherence to practice of LQMS, and assess the facility factors affecting adherence to the practice of LQMS. Methodology: The study was a descriptive cross-sectional survey. Standard WHO-AFRO observational checklist and key informant (quantitative) questionnaire guide data collection tools were utilized. Four (4) lab managers and eight (8) quality officer or safety officers participated in the study. The study evidently achieved the objectives set forth. Results: The study found out that, Lab 1 (Mengo) adhered at 79.07%, Lab 2 (Nsambya) adhered at 86.43%, Lab 3 (Lubaga) adhered at 58.53%, and Lab 4 (Kibuli) adhered at 59.69%. Specifically the study findings were that process factors were the major factor influencing the adherence to practice of LQMS as 3⁄4 labs scored below 50%, in management review 3⁄4 labs scored below 7/17 (41%). In internal audits all the PNFP labs scored below 4/10 (40%), in process control 2 of the labs scored below 19/33 (58%). Corrective action and occurrence management 2 of the labs scored below 4/12 (29%) respectively. The main human resource factors influencing the practice of LQMS were identified as lack of competency assessment, quality officers, training policies, procedures, plans and mentorship. The facility and safety indicated equipment validation and calibration was influencing the quality system and 2 of the labs scored poorly 26/43 (62%) each in infrastructure and safety installations. Human resource factors were 3⁄4 labs scored below 13/20 (65%), in facility and safety 2 of the labs scored 26/43 (65%) respectively. There was no significant difference in the process factors (p-value <0.001). The ANOVA statistics indicates positive regression model at p=0.042. The process factors were found to be the most influential factor in the practice of LQMS. Conclusion: The study established that process factors influenced the practice of LQMS more than the human resource, equipment and the facility and safety factors, evidenced by the process factors constituting 70% of the checklist questions and the poor performance in the process factors like internal audits. Recommendations: Based on the study findings, the major recommendations included; initiation and regularize the conduct of lab audits as a means of gap identification and opportunity for continuous quality improvement. Conduct regular management reviews, the lab managers should participate in facility management and budget meetings where resource allocations decisions are made. Lab managers should ensure conduct of internal audits, process control, quality assurance and quality control, proficiency testing, external quality assessment, occurrence management and instituting corrective action. Conduct staff competency assessment, identify training needs of the different cadres, and develop plans for trainings. The facility should develop clear lab organogram, with well-defined roles and responsibilities of each level to improve the chain of command within the lab. Labs should participate in equipment validation and calibration exercises to ensure precision and accuracy of aliquots. In line with need for further inquiry, the study identified the following areas for further research; the influence of attitude on the practice of LQMS, the influence of training and mentorship on practice of LQMS and influence of cost of quality on practice of the LQMS.
Adherence to laboratory test results in the management of malaria in KCCA health centers in Kampala city, Uganda.
(International Health Sciences University., 2015-12) Sule, Shuaibu; Umaru.
Introduction: This study aimed at assessing the levels of adherence to laboratory test results in the management of malaria in KCCA health centers in Kampala City, Uganda. This was on the basis of the facts that the prescription practices of health workers in malaria management investigated in earlier studies appeared not to have changed despite the various strategies on dissemination exercise of these guidelines and policy by Uganda MoH. Objectives: The study had three specific objectives; To determine the level of adherence by health workers to laboratory test results in the management of malaria, to identify health worker factors affecting adherence to laboratory test results in the management of malaria, and to identify the health facility factors affecting adherence to laboratory test results in the management of malaria in KCCA health centers in Kampala City, Uganda. Methodology: Cross-sectional survey design was adopted for this study. Secondary data was collected using documents review from outpatient’s records, laboratory test for malaria and Acts prescription records for the month of June, July and August, 2015 to establish level of adherence in the health centers. Primary data was collected using self-administered questionnaires, focus group discussions and key informant interviews to establish other factors affecting adherence to laboratory test results in the management of malaria following the WHO/ MoH policy guidelines. Data was analyzed using Epi-data and SPSS which was presented using descriptive statistics of frequencies and percentages. The chi-square test was used as bivariate analysis to test the level of association between the variables of the study while logistic regression was used as multivariate analysis to determine the influence of the independent variables on the dependent variable. Findings: Documents reviewed from the health centers revealed low levels of adherence to laboratory test results in the management of malaria during the months of June, July and August, 2015. Findings from this study revealed that of the 15,169 patients treated with ACTs in the health centers, up to 13,309(87.7%) were either malaria negative or not tested. The level of compliance to WHO/UNMCP malaria treatment guidelines was only 12.3% which is very low. There is significant association between; Awareness of the policy (χ2 = 7.759, p = 0.008, and AOR = 4.307), Health worker attitudes (χ2 = 9.041, p = 0.029 and AOR = 0.415) and Results delivery time (χ2 = 13.650, p = 0.000 and AOR = 6.884) on the dependent variable. Conclusion and Recommendations: The study revealed that adherence to laboratory test results in the management of malaria in KCCA health centers, Kampala City as generally low. Therefore MoH and KCCA should plan new strategies that should be used to ensure policy implementation in order to achieve the benefit of adherence to laboratory test results in the management of malaria as recommended by WHO.
Adherence to Occupational Safety and Health Measures by Employees in Selected Restaurants in Kampala District.
(International Health Sciences University, 2013-09) Zipporah, Ajambo
Background The study was carried out to identify the reasons for low levels of adherence to occupational safety and health measures among the restaurant workers. The study was done because despite the availability of effective interventions to prevent occupational hazards and to protect and promote health at work place, there are still noticeable accidents among employees in restaurants due to gaps in adherence to OSH measures. Objective The main objective under study was to assess the factors influencing the adherence to occupational safety and health measures by employees in selected restaurants in Kampala District. Methodology The study followed quantitative and qualitative research methods using a cross-sectional survey design. The target population comprised of restaurant kitchen workers including; chefs, waiters, waitresses, managers and cleaners in the selected restaurants and 230 workers were interviewed. Purposive sampling procedure was employed to provide the data relevant to the study. Research administered questionnaires and key informant interviews were used to collect data. With the quantitative tools, the analysis was done using the statistical package for social sciences (SPSS 16.0) programme, Microsoft excel, absolute figures, tables, percentages and statistical tools such as graphs, charts were used. Whereas for qualitative, analysis of feedback from interviews was done manually. Results The major findings in this study were as follows; Out of the 230 interviewed respondents, 54.40% of them adhered to OSH measures and the use of gloves was least adhered to with only 12 (5.2%) adherence. The study revealed that the restaurant population is also dominated by males with 124(53.9%) than females 106 (46.1%). At the bivariate analysis, under the socio-demographic factors, gender (p-value <0.001) and monthly income (p-value <0.001) were found to have a significant influence on the restaurant worker’s adherence to OSH measures. Awareness of precautionary measures against risks (p-value 0.035) and awareness of the importance of personal protective gears (p-value 0.023) were found to have some statistically significant influence on the restaurant worker’s adherence to OSH measures. Distance to work (p-value<0.048), cleaning schedule prepared (p-value<0.001) and company providing personal protective equipment (p-value <0.001) under the institutional factors were found to have a significant influence on the workers adherence to OSH measures. At multivariate analysis, under gender the males were 2.4 times more likely to adhere to OSH measures than the female workers (OR=2.4, 95% C.I 1.1-5.3, P-value=0.029). The restaurant workers who said were aware of the precautionary measures were 17 times more likely to adhere to safety measures than workers who were not aware (OR=16.9, 95% C.I6.7-42.7, P-value= <0.001). The workers who said that the management provided safety equipments were 3 times more likely to adhere to safety measures than those who claimed that management did not provide anything (OR=3.2, 95% C.I 1.5-6.8, P-value= 0.003). Conclusion and Recommendations In conclusion, the restaurant worker’s gender, knowledge of precautionary measures and their acknowledgement of management providing safety equipment significantly influenced their adherence to OSH measures at work. The study recommends emphasis be put on the female restaurant workers to adhere to safety measures, workers focusing on precautionary measures against risks at work and management of restaurants insisting on the availability of safety equipments.
Adherence to safety measures among employees of crown beverages limited in nakawa division, kampala capital city authority.
(International Health Sciences University., 2015-12) Nsereko, Patrick
Industrial workers are exposed to hazards in their work places as they engage in routine work, these hazards include physical, chemical, biological and mechanical. To reduce on the effect of these hazards, employees are provided with PPE as a last resort to prevent them from hazards that cannot be eliminated completely. The study on adherence to safety measures among employees of crown beverages limited was conducted to establish the factors that have contributed to non-adherence. The specific objectives of the study were; to establish workers level of knowledge on safety measures, to establish the effect of sociodemographic factors on adherence, to determine the practices and attitude of workers towards the use of PPE. A descriptive cross sectional study using a study sample of 201 respondents was employed using both Quantitative (Questionnaires) and Qualitative (Key informants and Observation) data collection methods were employed. Results from the study indicated 195 (97%) of the respondents were knowledgeable while 5 (2.5%) were not, the study also reflected 93 (46.3%) of the respondents had negative attitude towards the use of PPE while 102 (50.7%) had a positive attitude. The results showed an association between adherence and gender at p – value of 0.002 and adherence and occupation at p – value of 0.026, an association between number of years an individual has spent at work and adherence at p-value 0.011 and an association between occupation and adherence at p-value 0.028. Based on the study, it was evident that the main factor affecting adherence to safety measures among employees of crown beverage limited was negative attitude of the employees towards the use of PPE. It’s therefore paramount for management of crown beverages limited to institute measures that can change the mind set of individuals but also to introduce tough measures for those individuals found in violation of the set safety measures.
Adherence to the Sewerage Treatment Plant Guidelines in Kampala:
(International Health Sciences University., 2016-11) Opoka, Paula; Sandra
Background: The study examined the level of adherence to the sewerage treatment guidelines at Lubigi sewage treatment plant.The study objectives were to;determine the safety management systems influencing adherence to the sewerage treatment guidelines at Lubigi sewage treatment plant; establish the safety environment aspects influencing adherence to the sewerage treatment guidelines at Lubigi sewage treatment plant and establish the employee safety commitment aspects influencing adherence to the sewerage treatment guidelines at Lubigi sewage treatment plant. Methods: The study used a cross sectional study design and data was collected from a sample of53respondents, self-administered questionnaires; and documentary review guides were used in the study. Results: The study results established that adherence to sewage treatment guidelines was significantly influenced by restricting exit or entry for authorized person to the sewage treatment area (X2 4.7,p-value 0.03). The study result established a significant relationship between level of adherence to sewage treatment plant guidelines and health and safety measures (X2 13.032, p-value 0.000). This study established an association between the level of adherence to sewage treatment guidelines and presence of manuals. Recommendations: It is recommended that employees must be trained in several aspects of personal protective equipment, these include, when personal protective equipment must be worn; what type of equipment is necessary, how to properly adjust, wear and remove the equipment. It is recommended that the managers should organise workshops that sensitize the workers about the occupational hazards that are likely to occur and cause serious injuries.The availability of a readily written and detailed operations and maintenance procedures is very vital to the adherence of the guidelines thus it is recommended that the plant can use the manual as a point of reference.
Adherence to Tuberculosis Infection Control Measures Among Health Workers in Bombo and Nakasongola Military Referal Hospitals.
(International Health Sciences University., 2014-11) Richard, Mpangire
Agricultural Practices, Food Security and Nutritional Status of Children Under Five Years in Kateta Sub- County Serere District.
(International Health Sciences University, 2014-11) Epero, Joseph
Main objective. The main aim of the research was to describe agriculture practices, food security and nutritional status of children under in Kateta sub county where malnutrition is on the increase among children. The influence of human capital as an intervening variable in terms of the extension workers and household heads is capacity in terms of knowledge and skills plays a role in nutritional status of children and therefore very critical in this research. Methodology. The methodology employed in this research involved the use of structured questionnaires with both closed and open ended questions which were administered to respondents from sampled households. The anthropometric data for children under five was analyzed using the Epi- info 2012 version enabled the generation of Z scores standard deviations used to provide a direct assessment of malnutrition among the age group. Key informant interviews were conducted with professionals in the fields of agriculture and health and helped to enrich the study especially on recommendations for action. Results. The main findings for the research include: the average households land holding is low at 1-3 acres yet there is also underutilization and the contribution of production to food is equally low yet there is competition of use of food for consumption and income which is used for other needs; households' involvement in modern agriculture practices is low and traditional practices dominate in the sub- county; children at the age of 0-11 months are more affected by underweight while children at the age of 36- 47 months are more affected by stunting ; there is lack of joint planning between the agriculture and health personnel in order to improve nutritional status of children under five and education levels fairly are good and fairly good and provide a potential for improvement in agricultural practices hence food security and nutrition status. Conclusion and recommendations. In conclusion, poor agricultural practice have contributed to food insecurity in Kateta sub county and this has negative influence on the nutritional status of the under fives. The study recommends thus; joint planning for agriculture by agriculture and health professionals so as to improve on diets, this is in agreement with the recommendation of global food policy report (2011); promote adoption of good agricultural practices; village health teams should handle nutrition support services for children under five through education; improve agricultural extension services; support adequate planning on food utilization.