Diploma Clinical Medicine and Community Health
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Item Factors Affecting The Practice Of Continuous Medical Education Among Medical Practitioners Of Mubende Regional Referral Hospital,Mubende District(CIU, 2018-12) Erima, TimothyABSTRACT Background: Continuous Medical Education, defined as any medical educational activity undertaken by physicians after graduation from medical school is essential for all medical practitioners for many important reasons. CME increases and improves the physician’s knowledge, skills, and performance which ensure the provision of high-quality healthcare services for patients and the public. Moreover, CME ensures that physicians have the basic and advanced medical knowledge and skills that are recognized and accepted within medical science. Aim: The aim of the study was to assess factors affecting the practice of CME among medical practitioners of MRRH, Mubende district Methods: A cross-sectional, questionnaire-based survey involved 100 medical practitioners who were practising at MRRH. The MPs included nurses, clinical officers and medical officers. The MPs were handed to complete the questionnaire on factors affecting the practice of continuous medical education. Data was collected and analyzed using SPSS software. Results: A total of 67.6% of the respondents practised CME sessions.98.7% attended CME to improve their medical knowledge and improve patient management techniques. 75% strongly agreed that CME is as important as other hospital undertakings. Only 13.4% respondent that attended CME rated it as excellent, while 77.6% rated it good. 98.5% of the respondents were notified for CME sessions by notice boards while only 1.5% of the respondents were notified by social media platforms that included WhatsApp, and rarely Facebook. 74% of the respondents said there‟s no specified time to attend a CME while 30% of the respondents reported that there’s a demarcated or protected time to practice CME. Conclusion: The MPs who were practising at MRRH had a more than average attendance or practice of CME and were determined to practice CME. The MPs attitude towards practices of CME was excellent hence could not be considered a factor that significantly affects their decisions to attend CME. Other forms of CME, that include: Radio CME, Internet Journals, TV journals were the least used type of CME used by MPs of MRRH, therefore has a negative significant impact on the decision to attend CME. Shortage of protected time off from daily hospital undertakings has a significant negative impact on the decision to practice CME. Recommendations: It is well known that medical education does not stop at any one point, due to dynamicity in technology and innovations, and the need to improve and update medical skills of all in-practice MPs continuously for a better hospital output and patient satisfaction, the hospital administrators should provide protected and demarcated time for MPs to practice CME. 1Item Knowledge And Practices Of Mothers Towards Complementary Feeding Practices Of Children Aged 6 To 24 Mothers In Kobwin Parish,Kobwin Subcounty Ngora District(CIU, 2018-12) Angiro, JohnsonABSTRACT Background information: Malnutrition related to inadequate CF is responsible for about 10 million annual deaths of under 5 children (UNICEF, 2012) despite the effective intervention strategy for malnutrition of recommending the introduction of complementary foods at 6 months with continued BF for 2 years or more made by WHO, 2010. Aim of the study: This study intended to assess the knowledge and practices of mothers towards complementary feeding practices of children aged 6 to 24 months in Kobwin parish, Kobwin sub-county Ngora district. Research methods: The study employed a cross-sectional study design and majorly quantitative data was collected. The analysis was conducted using univariate and bivariate procedures to determine variables that were statistically significant with complementary feeding among mothers. Results: Results revealed that the majority of mothers (62%) in the selected sample were knowledgeable on complementary feeding. The majority knew that complementary foods are introduced at six months and it was evident that 62% of babies received foods by 6 months although (41.0%) of the babies were introduced to complementary foods at 6 months. All the mothers (100%) knew that it was necessary to continue breastfeeding babies even after introducing complementary foods. Their practices were also good since majority of them washed their hands before feeding children and they stored baby’s food safely. Study Conclusions: The study concluded that mothers were knowledgeable and their practices were good.Item Knowledge,Attitude And Practices Of Midwives Towards The Causes Of Puerperal Sepsis Among Mothers In St Monica Health Center III, Mpigi(CIU, 2018-12) Mutyaba, IbrahimABSTRACT Introduction and background; Globally, puerperal sepsis remains a big challenge especially in the least developed where hygiene is poor. Sepsis complicates obstetric conditions and risks the lives of numerous mother (Sandrock and Albertson, 2010). It is an important public health problem in developing countries where it is the third biggest cause of maternal mortality after haemorrhage and anaemia and one of the commonest causes of mortality among post-natal mothers (Dellinger et al, 2008). This study assessed the knowledge, attitude and management practices of midwives towards the causes of puerperal sepsis among post-operative mothers in Monica Health Center IIIMpigi district Methods and design; 50 participants (midwives) were enrolled. It was an observational cross-sectional study employing both quantitative and semi qualitative approaches. Data collected was coded, cleaned, edited, and entered into the computer for analysis using the SPSS version 12.0 software. Results; The study found the following on participants knowledge of how a mother with puerperal sepsis presents; 90%(45) with tender abdomen, 86%(45) with Pus discharge from the birth canal, 80%(40) with High fever above 38 degrees and Foul smell from the birth canal respectively. majority of the participants stated the following as the causes of puerperal sepsis; 86.0%(43) said poor hygiene, 88.0%(44) Use of native medicines, 76.0%(38) Poor diet and nutrition, 56%(28) said Low socioeconomic status while 44.0% said No, 84.0%(42) delivery from TBAs and lastly 58.0%(29). 84.0%(42) knew that puerperal sepsis can be spread from one mother to another while 16.0%(8) didn’t know. 84.0%(42) knew that puerperal sepsis can be spread from one mother to another while 16.0%(8) didn’t know. 58%(29) screened pregnant mother for sepsis every time they come for a visit to the health facility, 28%(14) screened once on every visit while 14% (7) never screen at all Conclusions; The study successfully showed that midwives have adequate knowledge of puerperal sepsis, show good attitude towards mothers with sepsis and employ proper practices for prevention and care for mothers with sepsis. Recommendations; Midwives continue to sensitize mothers regularly on the importance of post-delivery hygiene to prevent sepsis. The midwives continue; to practice safe and highly hygienic delivery processes.Item Prevalence And Factors Associated With Neonatal Mortality In China Uganda Friendship Hospital,Naguru(CIU, 2018-12) Mujooga, LawrenciaABSTRACT Introduction: The most defenceless period in the newborn’s life is the neonatal period which starts at birth and ends 28 days after birth: Since improving newborn health is a priority for the Ministry of Health Uganda, and the national neonatal mortality rate is at 20.2 per 1000 live births, a study on the factors that contribute to neonatal mortality was worth as the main causes of neonatal deaths are preventable. Objective: The main objective of this study was to determine the prevalence and factors associated with neonatal mortality in China Uganda Friendship Hospital, Naguru Methods: The study used a quantitative research approach with a retrospective descriptive study design to investigate factors contributing to neonatal mortality: data was collected using a checklist, from a population of 50 record files of all neonates who died during the period January 2017 and January 2018 from China Uganda Friendship hospital before 28 completed days of life. Data was then entered and analyzed with SPSS version 18.0 computer software. Results: From a total of 50 record files, 52.0 %(26) of the neonates‟ mothers were between ages of 20 to 29 years. 44.0% resided in rural areas, 18.0% were from Urban and 19(38.0%) were from Peri-urban regions. 22(44.0%) of the mothers had attained secondary education and 39(78.0%) were married. 34.0% were doing non-salaried jobs and 48.0% were housewives. 78.0% of the mothers were healthy at the time of giving birth while about 8(16.0%) were Sero-positive, 2(4.0%) hypertensive and 1(2.0%) was diabetic. 52.0%(26) of the mothers were Para 1+: 32(64.0%) delivered by SVD, 15(30.0%) by caesarian section while 3(6.0%) had a vacuum delivery. 28(56.0%) of the neonates were females and 22(44.0%) were males. 52.0%(26) of the neonates weighed between 1.6 to 3.5Kg; 8.0%(4) scored <5 Apgar in the first minute and about 26.0%(13) died within 24 hours following birth. 22.0% of the neonates had low birth weight and 10(20.0%) were premature. 58.0%(29), 12.0%(6) died of sepsis and RDS respectively. Conclusion: Most of the neonatal deaths resulted from preventable causes of neonatal mortalityItem Factors Influencing Maternal Death Among Mothers Who Seek Maternal Health Services At Iganga District-Eastern Uganda(CIU, 2018-12) Batambuze, UmarABSTRACT General Objective: The purpose of this study was to assess the factors influencing maternal death among mothers who seek maternal health services at Iganga hospital, Iganga district eastern Uganda Method: The study used a retrospective chart review (RCR) design, among 384 women who had received maternity services (ANC, maternity or PNC) from Iganga hospital in 2017. Iganga hospital was purposively sampled, while systematic random sampling was used to sample the patient files. The data collection method for this study was the medical data abstraction method and the tool that was used as the data abstraction form. Data were analyses using statistical Package for the Social Sciences (SPSS) version 20.0 Results: Almost all women whose records were reviewed were alive at the end of the 42 days postpartum (n = 369, 96%), less than a tenth of them had died during pregnancy, childbirth or within 42 days after birth (n = 15, 4%). There were three obstetric characteristics which had a statistically significant relationship with maternal survival or death. They were; gravidity (X2 = 35.421, p = 0.000), Postpartum hemorrhage (X2 = 6.137, P = 0.013), and were the patient was admitted from (X2 = 11.414, p = 0.010). None of the socio-demographic characteristics had a statistically significant relationship with maternal death or survival among women who had sought maternal health services from Iganga hospital in the year 2017 Conclusion: The maternal mortality rate at Iganga hospital in the year 2017 was 390 deaths per 100,000 live births, given that 15 women died among every 384 who gave birth at Iganga hospital. That maternal mortality rate is determined by majorly obstetric factors and to no extent by socio-demographic characteristics of the women. Recommendation: The administration of Iganga hospital should strengthen the practices of SBA, by first of all ensuring that all SBA adhere to guidelines for the management of all stages of labour, strengthen the policy of postpartum family planning among especially grand multigravida women so that after the fifth pregnancy, can have longer birth intervals and hence mitigate effects of short birth intervals that increase the risk of mortality during subsequent births. The district health office should lobby for more motorized ambulances, strengthen the referral and communication systems between lower health centres and Iganga hospital so that referral cases for complicated pregnancies receive timely emergency care. The government should increase on the manpower through employing health workers especially SBA (midwives) and doctors to handle obstetric emergencies and complications, avail medical supplies to through NMS to facilities that handle maternal health services, should also make sure that health workers are linked up with strong referral system carries out deliveries irrespective of whether births take place at home or at hospital and finally the government should develop minimal infrastructures for providing ANC and delivery care services.Item Assessment Of Patients Satisfaction With Health Care Services At The Out-Patient Department Of Naguru-China Hospital(CIU, 2018-12) Okello, HillaryABSTRACT Introduction: Patients‟ satisfaction remains an important indicator for quality health services and in order to ensure to promote patients‟ health seeking behaviors it is important to pinpoint which areas at the Outpatient department of a hospital causes patients to lose satisfaction in the service. Objectives of the study: To assess patients‟ satisfaction with; medical services, waiting time and the organizational care at the OPD of NCH. Methods: A cross-sectional study done with real-time data collection. Tools such as standard questionnaires and an observational checklist were employed. For analysis, Microsoft excel was used for data entry and transfers were made to IBM SPSS Version 23 for analysis. Results: Overall, patients‟ opinion was observed to be fairly good and appeared to be fairly satisfied with the health services at OPD in NCH. With much praise going to the availability of drugs and staff being present to attend to patients. Also the dress code of the staff showed professionalism and brought satisfaction to most of the patients. However, the downsides are in queuing indiscipline by other patients while in line to receive drugs, also long waiting time while at the consultation area. Conclusion: Most patients appreciate the presence of the facility design that accommodates handicapped patients and those using wheel chairs, also the presence of most drugs was noted and professionalism by the staff especially in courtesy and dress code. Other than that, the only challenges were in long waiting times of more than 1 hour by over 68.4% of the patients experiencing this. Recommendations: The research study identified key areas that can be improved in order to promote patients‟ satisfaction with the health services received at the OPD in NCH. Areas such as waiting time to see the doctor; this could probably be solved by having more staff to tackle the big load of patients flowing into the OPD and also starting time can also be adjusted so as to manage the patients faster and earlier.Item Attitude Of the Seronegative Partner Towards The Index Partner In HIV-Serodiscordant Relationships At The Aids Support Organisation,Mbarara, Uganda(CIU, 2018-12) Ataryeba, HenonABSTRACT Background: The aim of the study was to find out the attitude of the HIV-seronegative partner towards the index partner in HIV-serodiscordant relationships. Due to their constant and frequent exposure, HIV-serodiscordant couples are among the high-risk people for acquiring HIV. For effective prevention, care and support services, there is a need to understand the attitude of the seronegative partner towards the index in discordant relationships which directly affects prevention. Methods: In this cross-sectional descriptive study, a total of 73 respondents who were in discordant relationships were voluntarily enrolled for this study which employed both qualitative and quantitative methods to interpret the data obtained. The respondents were recruited using convenient consecutive sampling and a questionnaire was used to extract primary data. Data were analysed using the SPSS package and MS Excel. Results: Of the 73 seronegative partners investigated, 25 (35.61%) were male, while 48 (64.38%) were female. Attitude findings were largely positive; social support (80.90%), treatment support at (79.50%), of the negative attitudes, anxiety (63.00%), sexual avoidance (53.40%), risk compensation (52.10%), were the highest. Furthermore, the findings on the effect of serodiscordance on couple or families at large were broad including increased social support with disclosure before the relationship, physical violence, rape, stigma, discrimination, just to mention a few. The study got a finding that most couples were using a blend of two or more preventive strategies with condoms being the most used method. Conclusion: Generally, men are most likely HIV positive in discordant relationships and there is no poor attitude towards the index partner in discordant relationships. However, there are some isolated cases of an extremely poor attitude. Recommendations: HIV prevention programs should be more focused on men; SMC. There is also an urgent need for female-initiated and controlled preventive measures. PrEP should be given as part of a preventive package including screening for long term toxicities and resistance; prevention should not be limited to one method. Last but not least, there is a need for community-based counselling services.Item Factors Affecting The Uptake Of Routine Dental HealthCare Services Among Adults 18 Years And Above,At Mubende Regional Referral Hospital,Central Uganda.(CIU, 2018-12) Nalugya Grace, VictoriaABSTRACT Background: Oral health is a fundamental component to general health, and is essential for individuals to enable them to communicate effectively, have a positive quality of life, and maintain self-esteem and social self-confidence as well as prevention of diseases. (Masoe et al, 2014). Oral diseases and conditions have increasingly become prevalent because of their high impact on individuals’ social and economic daily life. (Machado et al 2012). Dental carries alone are reported among the high burden oral conditions with a prevalence ranging between 60% and 90% worldwide (WHO, 2015). In Uganda, dental diseases are reported to be rampant with a prevalence of 62.5% (Okullo et al 2015). The study assessed the factors affecting the uptake routine dental healthcare services among adults 18 years and above, at Mubende Regional Referral Hospital. Methodology: The study was conducted at the Mubende Regional Referral Hospital dental outpatient Clinic in Mubende district. The descriptive cross-sectional study design was used to conduct this facility-based study, with a sample size of 138 respondents. The primary sample subjects were randomly selected and were adults (≥ 18 years) who attended MRRH at OPD. Results: The study findings revealed that: 6 out of 138 which is around (4.35%) go regularly/routinely for dental checkup well as 64 (91.4%) go only when they have a toothache or some other dental problem. Majority 3 (50%) of respondents who went for routine dental checkups were 28-37 years, 33.3% (2) were 18-27 years and 1 (16.7%) was 38-47 age bracket. Most respondents who went for routine dental checkups were female and had attained tertiary education. Majority 3 (50%) were self-employed, 2 (33.3%) were civil servants and only 1 (16.7%) was a student. Conclusion and recommendations: Prevalence of routine dental checkup was very low. Low level of education, low socio-economic state, Long distance from health facility, long waiting time/delays, few dental health workers and cost were a hindrance to the routine uptake of dental health services. The Ministry of Health under the Primary Health Care section should encourage dissemination of oral health education to the community through seminars. This can be done at the district level by the dental professionals and would be best if integrated with other ongoing seminars like those for HIV/AIDS Programs. The Ministry of Health should implement a surveillance system to monitor patterns of oral disease and routine uptake of dental health care services, at local or district level so that proper planning is done.Item Factors Contributing to Teenage Pregnancy Among Mothers Attending Antenatl Care At Kitebi Health Centre III, Rubaga Division,KCCA-Uganda(CIU, 2018-12) Nakyagulanyi, JoanitahABSTRACT Background: Teenage pregnancy is an evolving global public health problem. Determining factors that contribute to teenage pregnancy could predict behaviours and take effect on less sexual risk behaviours in teenagers. Objective: To assess factors contributing to teenage pregnancy among teenage mothers attending antenatal care at Kitebi health centre III, Rubaga Division, KCCA - Uganda. Methods: A community based descriptive cross-sectional analytical study which employed 103 participants was carried out on mothers attending antenatal from the teenage centre of Kitebi HCIII in September 2018, using both quantitative and qualitative methods. Quantitative data was collected using pretested structural questionnaires and qualitative data was collected using focus group discussions (FGDs) with the help of an interview guide. Data were then processed qualitatively and quantitatively and analyzed manually with the help of Statistical Package for social sciences (SPSS) program. Pearson chi-square tests were also used to show the association between the independent and dependent variables. Quantitative data were presented descriptively in terms of figures and tables while qualitative data was presented in words. Results: of the 103 respondents, most of the teenage mothers were residents of Kitebi: individual, institutional, and socio-demographic factors were identified as risk factors for teenage pregnancy. Utilization of contraceptive FP was low and the majority of the teenage mothers reported to have had sex education from peers at school, who had scanty information on matters of sex and contraceptive FP. Conclusion: Based on the study findings; family dysfunction, peer pressure, level of education, low household income, sexual abuse, inaccessibility and in-affordability of contraceptive family planning services have led to an increase in the rate of teenage pregnancy. Therefore, the study recommended; incorporation of sex education in secondary school syllabus, establishment of teenage friendly centres in most government health facilities, involving young people to talk about sexuality issues, relationships, targeting high risk groups- secondary school students; strengthening of community based programmes that sensitize communities on the implications of early pregnancy on both the teenager, her baby, family and Uganda as a whole.Item Knowledge,Attitude And Practices On Infection Prevention Among Staff Working On The Maternity Ward of(CIU, 2018-12) Natukunda, SharonABSTRACT Background: Infection prevention and control is a practical evidence-based approach which prevents patients and health workers from being harmed and ensures quality health care. Knowledge and practice of standard precaution measures can enhance infection control within the health facilities. These are hand hygiene, adequate protective wear, proper sterilization, proper sharps disposal and safe waste management. Objective: We sought to assess the knowledge, attitude and practice on infection prevention and control among Mubende regional referral hospital (MRRH) staff, Uganda Methods: A cross-sectional study survey was conducted among 174 medical staff of MRRH. A self-administered questionnaire was used for data collection. Statistical software for scientists SPSS version 16 was used for data analysis. A 95% confidence interval was considered in this study. Results: Based on the data obtained from survey respondents, the results of the analysis showed that respondents are knowledgeable about infections: their aetiology, risk factors for their transmission and the recommended guidelines for reducing their spread. Conclusion and Recommendations: Finally, significant organizational support is needed to lend support to the reduced occurrence of infections. Organizational support plays a pivotal role in the implementation of strategies known to reduce the spread of infections.Item Factors Associated With Infant And Child Mortality At Kuluva Hospital,Arua District(CIU, 2018-12) Lekuru, AsikiABSTRACT Introduction. Child mortality also called under five mortality is the number of deaths of infants and children under the age of five .Infant and child mortality being a basic indicators of a countries socio economic situation and quality of life, a cross sectional study was done in August 2018 at Kuluva hospital to assess factors associated with infant and child mortality in Vuura subcounty. . Aim: The aim of the study was to determine the factors associated with infant and child mortality at Kuluva hospital, Arua district”. Methods: Simple random sampling method was used to select study respondents and 92 respondents. Were selected for the study and a pre- tested questionnaire was used to collect data from them. The data was analyzed using SPSS and presented as a narrative and as figures. Results: The findings were such that the maternal and child factors associated with infant and child mortality at Kuluva hospital were financial status of the mother (R= - 0.481, P= 0.001) and maternal level of education (R= 0.651; P= 0.0001). and rules out Maternal age, child’s gestational age, duration of breastfeeding feeding, child’s weight and health status of preceding child as causes of infant and child mortality. The socio-economic factors contributing to infant and child mortality and morbidity at Kuluva hospital were poverty (83.3%) associated with occupation of being a peasant and inability meet financial obligations and long distance to nearest health facility (73.3%) coupled with lack of transport money (47.8%). The health and facility related factors contributing to infant and child mortality and morbidity at Kuluva hospital was inadequacy of health workers by numbers (83.7%), ( P= 0.003) Conclusion: Maternal level of education, maternal financial status and adequacy of health workers and distance of nearest health facility were found to be important predictors of infant and child mortality whereas child related factors were found to have an independent relationship with child mortality . Recommendations: The government of Uganda through its ministry of education and sports further enforces and strengthens its universal primary and secondary education programs to raise literacy levels so as to minimize infant and child mortality. It was also recommended that the Uganda Protestant Medical Bureau should build and equip more health centers to reduce on distance travelled to the nearest health facility. The management of Kuluva hospital should recruit more staff in order to improve on its staffing numbers and it should as well find more partners and donors in order to further reduce costs of the services it renders to the people. This will improve health seeking behavior of these people and subsequently lower the infant and child morbidity and mortality.ABSTRACT Introduction. Child mortality also called under five mortality is the number of deaths of infants and children under the age of five .Infant and child mortality being a basic indicators of a countries socio economic situation and quality of life, a cross sectional study was done in August 2018 at Kuluva hospital to assess factors associated with infant and child mortality in Vuura subcounty. . Aim: The aim of the study was to determine the factors associated with infant and child mortality at Kuluva hospital, Arua district”. Methods: Simple random sampling method was used to select study respondents and 92 respondents. Were selected for the study and a pre- tested questionnaire was used to collect data from them. The data was analyzed using SPSS and presented as a narrative and as figures. Results: The findings were such that the maternal and child factors associated with infant and child mortality at Kuluva hospital were financial status of the mother (R= - 0.481, P= 0.001) and maternal level of education (R= 0.651; P= 0.0001). and rules out Maternal age, child’s gestational age, duration of breastfeeding feeding, child’s weight and health status of preceding child as causes of infant and child mortality. The socio-economic factors contributing to infant and child mortality and morbidity at Kuluva hospital were poverty (83.3%) associated with occupation of being a peasant and inability meet financial obligations and long distance to nearest health facility (73.3%) coupled with lack of transport money (47.8%). The health and facility related factors contributing to infant and child mortality and morbidity at Kuluva hospital was inadequacy of health workers by numbers (83.7%), ( P= 0.003) Conclusion: Maternal level of education, maternal financial status and adequacy of health workers and distance of nearest health facility were found to be important predictors of infant and child mortality whereas child related factors were found to have an independent relationship with child mortality . Recommendations: The government of Uganda through its ministry of education and sports further enforces and strengthens its universal primary and secondary education programs to raise literacy levels so as to minimize infant and child mortality. It was also recommended that the Uganda Protestant Medical Bureau should build and equip more health centers to reduce on distance travelled to the nearest health facility. The management of Kuluva hospital should recruit more staff in order to improve on its staffing numbers and it should as well find more partners and donors in order to further reduce costs of the services it renders to the people. This will improve health seeking behavior of these people and subsequently lower the infant and child morbidity and mortality.Item Factors Associated With Infant And Child Mortality At Kuluva Hospital,Arua District(CIU, 2018-12) Lekuru, AsikiABSTRACT Introduction. Child mortality also called under five mortality is the number of deaths of infants and children under the age of five .Infant and child mortality being a basic indicators of a countries socio economic situation and quality of life, a cross sectional study was done in August 2018 at Kuluva hospital to assess factors associated with infant and child mortality in Vuura subcounty. . Aim: The aim of the study was to determine the factors associated with infant and child mortality at Kuluva hospital, Arua district”. Methods: Simple random sampling method was used to select study respondents and 92 respondents. Were selected for the study and a pre- tested questionnaire was used to collect data from them. The data was analyzed using SPSS and presented as a narrative and as figures. Results: The findings were such that the maternal and child factors associated with infant and child mortality at Kuluva hospital were financial status of the mother (R= - 0.481, P= 0.001) and maternal level of education (R= 0.651; P= 0.0001). and rules out Maternal age, child’s gestational age, duration of breastfeeding feeding, child’s weight and health status of preceding child as causes of infant and child mortality. The socio-economic factors contributing to infant and child mortality and morbidity at Kuluva hospital were poverty (83.3%) associated with occupation of being a peasant and inability meet financial obligations and long distance to nearest health facility (73.3%) coupled with lack of transport money (47.8%). The health and facility related factors contributing to infant and child mortality and morbidity at Kuluva hospital was inadequacy of health workers by numbers (83.7%), ( P= 0.003) Conclusion: Maternal level of education, maternal financial status and adequacy of health workers and distance of nearest health facility were found to be important predictors of infant and child mortality whereas child related factors were found to have an independent relationship with child mortality . Recommendations: The government of Uganda through its ministry of education and sports further enforces and strengthens its universal primary and secondary education programs to raise literacy levels so as to minimize infant and child mortality. It was also recommended that the Uganda Protestant Medical Bureau should build and equip more health centers to reduce on distance travelled to the nearest health facility. The management of Kuluva hospital should recruit more staff in order to improve on its staffing numbers and it should as well find more partners and donors in order to further reduce costs of the services it renders to the people. This will improve health seeking behavior of these people and subsequently lower the infant and child morbidity and mortality.Item Knowledge,Attitude And Practices Of Sickle Cell Disease Screening Of Secondary School Students In Namanve Village Goma Division, Mukono District(CIU, 2018-12) Bukirwa, SarafinahABSTRACT Background: Sickle cell disease is still prevalent in Uganda where 15,000 to 20,000 babies are born with sickle cell disease every year and 80% of them, unfortunately, die before their 5th birthday. Therefore, this study is aimed at assessing the knowledge, attitude and practice among adolescents on menstruation and associated with sickle cell disease screening among secondary school students in Namanve, Goma division, Mukono district. Methods: A cross-sectional study design was used to gather information on knowledge, attitudes and practice on sickle cell disease screening between the months of September and October 2018. Results: Samples of 245 respondents were interviewed and out of that 38.37 % had never screened for sickle cell disease. According to this study findings, sickle cell disease screening was determined by parent‟s occupation, regular health check-ups, feeling sympathy for people with SCD (OR=3.526, CI (1.063-11.699) among others. Conclusion: This study found out that there is still a high prevalence of SCD and screening is still low. Thus the risk factors established are controllable, avoidable and some are preventable. The concerned stakeholders are therefore informed about them so that positive measures may be put in place to control the disease. Recommendation: Medical and public health intervention should be directed towards the promotion of sickle cell disease screening.Item Factors Influencing Multidose Vaccines Coverage Among Children 2-5 Years In Kakira Town Council,Jinja District(CIU, 2018-12) Mbabazi, DoreenABSTRACT Introduction: Immunization among all children guarantees protection from the immunizable diseases but multidose vaccines has remained a challenge. The main objective of this study was to assess factors influencing multi-dose vaccines completion among children two to five years in KTC Methods: A cross-sectional descriptive study design was used. The study sought approval from the local council III chief and the University. Data was collected from 138 respondents selected by consecutive sampling and convenience methods. Using Epi-data Version 3.1, a SPSS file was generated and then exported to STATA 10.0 for analysis. Results: Of the 138 respondents, 49(35.5%) had not completed the all the doses with completion seen better with OPV, PCV, and DPT was 90.6%, 87.0%, and 81.2% respectively. Fear of side effects of vaccination 42(30.43%), health facility being far 19(13.77%), forgetting the immunization dates 44(31.88%), and wife/ husband not being supportive 31(22.46%) were some of the reasons for not completing vaccination. The marital status (X2=4.896, P=0.027), child’s age (X2=0.5204, P=0.023), education level of respondent (X2=1.258, P=0.004) significantly affected multidose vaccines coverage. Conclusion and Recommendation: the study documented low multidose vaccine coverage in children two to five years of Kakira town council. Substantial improvement in outreach immunization programmes, health education and encouragement of mothers to attend antenatal will help improve multidose vaccine coverage both in rural and urban areasItem Barriers To Exclusive Breast-Feeding Among Mothers Attending Post-Natal Clinic In Mubende Regional Referral Hospital,Mubende District-Uganda(CIU, 2018-12) Nakaweesi, VioletABSTRACT Background: Exclusive breastfeeding refers to a process where an infant is fed with milk from the mother's breast only without any supplementary feeds. The nutritional needs of a normal full-term baby have been found to be adequately met by the breast milk of a healthy mother for the first four to six months of life. Scientific evidence is bound on the unique life-sustaining properties of breast milk, which no other substitute possesses. Breast feeding is very important for the mothers as well. Objective: Barriers for exclusive breast feeding among 80 mothers attending post-natal clinic in Mubende regional referral hospital. Method: This was descriptive cross sectional study on 80 mothers attending post-natal clinic in Mubende regional referral hospital. Structured interviews were used to collect data on exclusive breastfeeding among the study respondents. Chi square tests were used to assess the association between socio-demographic, and role of ANC in exclusive with exclusive breastfeeding. All statistical tests were two-tailed and P-value less than 0.05 were considered significant. Results: The proportion of mothers that were breast feeding exclusively was at 38.8%%. The results showed maternal age (χ2=28.474, P-value of 0.009), child’s age (χ2=3.569, P-value of 0.037), place of delivery (χ2=56.339, P-value of 0.000), health status during delivery (χ2=5.209, P-value of 0.019),, initiation of breastfeeding (χ2=8.013, P-value of 0.090), marital status (χ2=1.389, P-value of 0.008), educational level (χ2=23.293, P-value of 0.031), employment status (χ2=12.694, P-value of 0.001), income level (χ2=7.115, P-value of 0.044) , Lessons concerning EBF (χ2=15.073, P-value of 0.007), the person who provide the lesson (χ2=9.802, P-value of 0.000) and meaning of Exclusive breast feeding (χ2=7.123, P-value of 0.026) were significantly associated with Exclusive breast feeding. Therefore, results showed a statistically significant association with barriers to exclusive breast feeding. Conclusion and recommendation: The prevalence of Exclusive breast feeding was low. It is recommended that Promoting institutional delivery, revising the leave after birth, advice and counseling pregnant mothers about EBF, and enabling every mother to encourage colostrum feeding are recommended in order to increase the proportion of women practicing exclusive breastfeedingItem Prevalence And Factors Associated With Use Of Herbal Medicine In Pregnancy Among Women Attending(CIU, 2018-12) Tumusiime, HabertABSTRACT Background: Practices during pregnancy involve a demand for antenatal care services and planning for healthy childbirth, including emergency preparedness, prevention of malaria, HIV testing and nutrition. However, the use of herbal medicines still stands to neglect formal standard medical care, therefore, this research aims at establishing determinants of use of herbal medicines among pregnant mothers attending antenatal care at MRRH. Methods: Hospital-based cross-sectional study design was used to carry out the study on factors influencing the use of herbal medicines among pregnant mothers attending antenatal clinic at MRRH. Results: Sample of 212 respondents were interviewed and out of that 74.1 % of participants were found to use herbal medicines. According to this study findings, use of herbal medicines was determined by preparation of herbal medicines (OR=0.054, 95%CI (0.019-0.155), reason for using herbal medicine while at ANC [OR=0.197, 95%CI (0.076-0.514), P-0.001), source of information about herbal medicines (OR=0.216, 95%CI (0.080-0.581) P-0.002) and paying for herbs (OR=0.373, 95%CI (0.197-0.704) P-0.002). Conclusion: The use of herbal medicine during pregnancy is a common practice and associated with rural residency illiteracy and low average education status, pregnant women mainly use and rely on friends, family members and support groups as their source of information about herbal medicines. Commonly used herbs were Aloe vera (Aloaceae), (Leguminosae) Omusisa, (Asteraceae) Omugino and (Sapindaceae) Omwataibale and the common indication that were given were cough, fever, pain, weakness, and skin rash among others. Given the high frequency of use of herbal medicine and a low rate of confession to the health workers at antenatal, hospitals and health centres need to train their health workers and also set up a program of open discussion with mothers about the effects of herbal medicines leading to a health outcome. Recommendation: More detailed surveys covering the factors associated with the use of herbal medicines in pregnancy remain to be undertaken to complete the documentation in Uganda so that the use of herbal drugs during pregnancy is assessed carefully.Item Assessing The Factors Affecting Quality Of Health Care Provision At Ayivuni Health Centre Three Ayivuni Sub-County Arua District-Uganda(CIU, 2018-12) Adriko, BenardABSTRACT Background \ Introduction The study was on assessing the factors affecting quality of health care provision at Ayivuni health center III Ayivuni sub-county Arua district from December 2017 to April 2018. It had identifying the factors affecting quality health care provision, determining the indicators of quality health care and how the quality of health care can be improved and maintained as the specific objectives. Methodology The study was descriptive, cross-sectional study in which both simple random sampling and non-probability sampling technique were employed. Qualitative and quantitative designs were used and questionnaire were used to collect data from 293 respondents who participated. Results The results of the study revealed that inadequacy of the basic health care inputs that is; human resource(98.6%), good communication between health workers and clients/patient (96.9%) financial resource (95.6%), physical infrastructures (94.2%) and equipment (95.6%) medicine and health supplies (100%), lack of motivation (100%) and gap in quality Assurance process affected health care provision (100%). Unemployment also indirectly influenced the quality of health service. Indicators of quality health care were found to be; patient satisfaction with care, patient’s education effectiveness, infection control, mortality and morbidity rate, effectiveness of care and timeliness. Basing on the findings, the study concluded that the quality of health service highly relied on available and adequacy of basic health care input that is; infrastructures, human resources medicine and health supplies and health financing. Lack of motivation, infrequent on job training also affected quality of health care on the other hand quality assurance process played a great role in improvement and maintenance of health care. The quality of health care in health center three was therefore still poor basing on above. From the study it is recommended that the MoH puts in place all the basic health care inputs, strengthens quality assurance processes in all health facilities, motivation of staff and provide continuous medical education to the health worker. Enough staffing should be undertaken so that staff can handle reasonable number of patients at a time and give quality healItem Item Factors Contributing To Neonatal Sepsis At China Uganda Friendship Hospital,Naguru Kampala.(CIU, 2018-12) Ndwaddewazibwa, DamalieABSTRACT This study was carried out to assess the maternal, neonatal and health facility related factors contributing to neonatal sepsis at china Uganda friendship hospital, naguru. Aim: To study the factors contributing to neonatal sepsis at China Uganda friendship hospital-Naguru. Methods: A cross sectional study was conducted. A total of 39 files of sick new-born children and 4 health workers were interviewed. Main outcome was new-born sepsis confirmed by complete blood count test and blood culture. Independent variables included; maternal factors, new-born factors and healthcare related factors. Relevant data of neonates born during the study period were obtained from their case records. A documented information about the diagnosis of neonatal sepsis and positive laboratory results were obtained. Statistical analysis was done using frequency tables, a pie chat and Chi-squares as applicable. 95 % confidence intervals and P values were determined Results: Among 39 live births, a total of 17 documented episodes of sepsis occurred among neonates (43.6%). Among the risk factors assessed, a significant association of with Age, HIV status, Health status and mode of delivery was observed. Conclusions: The study findings revealed that the proportion of neonatal sepsis among new-borns at China Uganda Friendship hospital Naguru was 43.6%. Irrespective of the presence of neonatal factors such as prematurity, asphyxia or very low birth weight, screening for neonatal sepsis is warranted in the presence of maternal risk factors like age, HIV status and mode of delivery as the former are more likely to be associated with neonatal sepsis. Lack of antenatal care or access to it at health facilities was likely to later result in more sick new-borns with sepsis. Poor breastfeeding by sick new-borns was a marker for serious bacterial infection. Therefore, health sensitization programs should encourage women to attend health facility antenatal care where they will receive health education about alternative feeding practices, screening and treatment for infections to prevent spread of infections to new-borns. Supply of antibiotics and sundries should be improved to sufficiently control sepsis within the health facility.Item Factors Contributing To Childhood Malnutrition Among Children Under Five Years In Alere Refugee Camp,Adjuman District(CIU, 2018-12) Wek Bol, Wol WekABSTRACT Background:Nutrition is an important public health intervention for children below the age of five years for any one developing country. In Uganda particularly, malnutrition remains a big threat to almost all regions in Uganda particularly in the West Nile belt part of Uganda (Corbett et al, 2010). Objective:The study assessed the factors contributing to childhood malnutrition among under 5 years children in Alere refugee camp, Adjumani district. Methodology:A descriptive cross-sectional study design was used and both quantitative and quantitative data was collected from 195 caregivers in Alere refugee settlement camp, Adjumani district using researcher administered semi-structured questionnaires and systematic sampling was used to select households for the study. Data was cleaned in Excel and exported to SPSS where analysis was done using univariate and bivariate procedures. Results were then presented in figures and tables and interpretations were made. Results: The majority of the children lay within less than 3 Standard Deviation and there were minor cases of severe acute malnutrition among the studied population. Bivariate analysis revealed that the factors that had an association with malnutrition were age of mother (X2=12.732, P-0.001), education level of mother (X2=9.931, P-0.016), and marital status of the mother (X2=11.632, P-0.003). Results showed that the factors found to have significant association were breastfeeding (X2=9.023, P-0.043) and complementary feeding (X2=10.382, P-0.004). Conclusion: Severe acute malnutrition among the children was low. The factors identified to influence severe acute malnutrition were low awareness on food preparation especially among children aged between 12 to 24 years when they are weaned.