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Browsing by Author "Auma, Anna Grace"

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Access to ART Services: Lived Experiences and Coping Strategies of HIV-Positive Persons With Visual Impairment in Lira District, Northern Uganda
(John Wiley & Sons Ltd, 2025) Acila, Gloria Ketty; Ijorea, Noeline Aju; Kabunga, Amir; Angom, Mercy Joy; Talemwa, Sandra; Ayer, Patrick; Auma, Anna Grace
Background: Despite progress in the HIV/AIDS response, marginalized populations persistently face unique challenges in accessing essential healthcare services, including antiretroviral therapy. The aim of this qualitative study is to explore and understand the lived experiences of individuals living with HIV and visual impairment in Lira District, Northern Uganda, specifically focusing on their access to antiretroviral therapy services. Additionally, the study is aimed at identifying and analyzing the coping strategies employed by this population in navigating the intersectionality of HIV and visual impairment. Methods: This qualitative study, conducted in Lira District, Northern Uganda, employed a descriptive phenomenological design. Thirty in-depth interviews were conducted at Lira Regional Referral Hospital, focusing on individuals living with both HIV and visual impairment. Data collection involved a semistructured interview guide, addressing key issues derived from a literature review. Thematic analysis was used for data analysis, guided by Braun and Clarke’s framework. Results: Participants (N = 30) exhibited diverse sociodemographic characteristics, with ages ranging from 19 to 68 years. A number of themes emerged during data analysis: individuals developing visual impairment before and after ART initiation. Emotional challenges, strained relationships, and perceived burdenship were common themes among participants. Limited understanding of the cause of sight loss and a heightened perceived risk of HIV infection were evident. Challenges in accessing ART services included transportation difficulties, negative attitudes from healthcare workers, and a lack of trust in community drug distribution points. Participants employed various coping strategies, including prayers/religion, reliance on social support networks, denial, acceptance, and community rehabilitation. Positive religious beliefs offered hope, while social support played a crucial role in adaptation. Community rehabilitation and support were highlighted as instrumental in aiding coping. Conclusion: Despite awareness about the risk of HIV infection, significant barriers persist in accessing ART services for persons with visual impairment. Coping strategies underscore the importance of addressing psychosocial aspects. Tailored interventions, education, and policy changes are imperative to enhance inclusivity and accessibility of healthcare services for this vulnerable population in Uganda.
An Analysis of Post-Traumatic Stress Disorder and Quality of Life Among Adults Living with HIV in Western Uganda
(HIV/AIDS - Research and Palliative, 2024) Kabunga, Amir; Kigongo, Eustes; Udho, Samson; Auma, Anna Grace; Tumwesigye, Raymond; Musinguzi, Marvin; Acup, Walter; Akello, Anne Ruth; Okalo, Ponsiano; Nabaziwa, Jannat; Shikanga, Enos Mwirotsi; Halima, Namata
Background: HIV/AIDS remains a significant global public health issue, profoundly impacting infected individuals. Living with HIV involves complex mental health dynamics, with post-traumatic stress disorder (PTSD) being a prevalent challenge. This study aims to examine the correlation between PTSD and quality of life among HIV-positive individuals in western Uganda. Material and Methods: Conducted between May and July 2023, this facility-based cross-sectional study surveyed 439 participants from four HIV clinics in southwestern Uganda. Data were collected through interviewer-administered questionnaires, analyzed using descriptive statistics, simple linear regression, and multiple linear regression (p<0.05). Results: Respondents had a mean age of 40.6 years, with 68.3% female, 54.9% married, and 55.1% lacking formal education. The reported PTSD prevalence among HIV-positive individuals was 33.7%, significantly correlating with reduced overall quality of life (β = −4.52; p<0.001). The social quality of life had the highest mean score of 14.24 (±3.45) while the environmental quality of life had the lowest mean score 11.89 (±2.68). Conclusion: Our study reveals a concerning prevalence of PTSD, affecting 1 in 3 individuals, emphasizing the pressing need for comprehensive mental health support within HIV care settings. We observed a significant negative impact of PTSD on overall quality of life, particularly in physical and social aspects. Integrating mental health screening into routine HIV care is crucial, using validated tools like the PSTD Checklist Civilian Version, alongside training for healthcare providers to recognize PTSD symptoms in the context of HIV diagnosis and treatment.
Burnout and coping mechanisms among healthcare professionals in central Uganda
(Psychiatry, 2024) Kabunga, Amir; Kigongo, Eustes; Okalo, Ponsiano; Udho, Samson; Auma, Anna Grace; Tumwesigye, Raymond; Akello, Anne Ruth; Musinguzi, Marvin; Acup, Walter; Nabaziwa, Jannat; Shikanga, Enos Mwirotsi; Namata, Haliama
Background: The escalating global prevalence of burnout among healthcare professionals poses a serious health concern. Recent studies focus on prevalence and predictors of burnout among healthcare providers, emphasizing the need for well-being interventions. This study investigates burnout and coping mechanisms among healthcare professionals in central Uganda, addressing the dearth of knowledge about coping strategies specific to the region. Methods: An analytical facility cross-sectional study was conducted in five healthcare facilities in central Uganda between June to July 2023. Participants included physicians, nurses, and technicians actively engaged in direct patient care. Data were collected using socio-demographic surveys, the Professional Quality of Life (ProQOL-5), and the Brief-COPE tools. Results: The study revealed a high prevalence of burnout, with 39.8% of participants experiencing significant levels. Active coping, positive reframing, and denial were negatively correlated with low burnout levels. Dysfunctional coping, specifically self-distraction and denial, showed positive correlations with average and high burnout levels. Emotion-focused coping mechanisms were not employed across burnout levels. Conclusions: The results emphasize the demanding nature of healthcare roles in the region and highlight the need for comprehensive, context-specific interventions to address burnout globally. While some healthcare professionals utilized adaptive strategies such as seeking social support, engaging in self-care activities, and utilizing problem-solving skills, others resorted to maladaptive coping mechanisms such as substance use and avoidance behaviors. This dichotomy highlights the need for targeted interventions to promote adaptive coping strategies and mitigate the negative impact of maladaptive behaviors on individual well-being and patient care
Burnout and quality of life among healthcare workers in central Uganda
(PLoS ONE, 2024) Kabunga, Amir; Kigongo, Eustes; Okalo, Ponsiano; Udho, Samson; Auma, Anna Grace; Tumwesigye, Raymond; Akello, Anne Ruth; Musinguzi, Marvin; Acup, Walter; Nabaziwa, Jannat; Shikanga, Enos Mwirotsi; Namata, Haliama
Background The widespread problem of burnout among healthcare workers is not only common but also a significant concern that impacts the entire healthcare system in Uganda. It is essential to understand the connection between burnout and quality of life among healthcare workers in the specific context of central Uganda, where healthcare professionals face high patient volumes, limited resources, exposure to infectious diseases, and socioeconomic challenges. This study examined the relationship between burnout and quality of life among healthcare workers in central Uganda. Methods This research utilized a cross-sectional study conducted across various healthcare settings in central Uganda. The data were analyzed at descriptive, bivariate, and multivariate levels. The relationship between dependent and independent variables was evaluated using an independent t-test for binary variables and a one-way analysis of variance (ANOVA) for categorical variables. Significance was determined with a reported p-value, with relationships deemed significant at p < 0.2. For multivariable analysis, multiple linear regression was employed using a forward selection method, with significance set at 5% (p < 0.05). Results Our findings indicate that nearly 40% of healthcare workers reported experiencing high levels of burnout. The average score for overall quality of life was 10.71 (±4.89), with variations observed across different domains. The study reveals a significant connection between socio-demographic factors, burnout, and overall quality of life, emphasizing the impact of job category, supervisory support, sleep quality, and burnout on the well-being of healthcare workers. Predictive analysis illustrates how these factors influence both overall quality of life scores and scores in specific domains. Particularly noteworthy is that nurses and technicians tend to have a lower quality of life compared to physicians. Conclusion The results underscore the relationship between socio-demographic factors, burnout, and particular aspects of quality of life. Notably, job category, supervisory support, sleep quality, and burnout stand out as significant factors shaping the well-being of healthcare workers. Nurses and technicians encounter distinct challenges, suggesting the need for interventions tailored to their needs. Addressing issues such as inadequate supervisory support, burnout, and sleep-related problems is recognized as a potential approach to improving the overall quality of life among healthcare workers.
Chronic stress and coping mechanisms among nurses in Lango sub-region, northern Uganda
(Wiley Nursing Open, 2023) Kabunga, Amir; Kigongo, Eustes; Udho, Samson; Auma, Anna Grace; Okalo, Ponsiano; Apili, Brenda; Namata, Halimah; Nalwoga, Viola
Aim: This study aimed to assess chronic stress and coping mechanisms among nurses in Lango sub-region, northern Uganda, conducted between May and June 2022. Design: Institutional-based cross-sectional design conducted between May and June 2022. Methods: The study included 498 participants recruited from six health facilities. A 12-Item Short Form Survey tool was used to collect data on chronic stress, while a researcher-developed questionnaire was used to collect data on coping strategies. Descriptive statistics, binary logistic regression and multiple regression were con ducted for data analysis. A p-value of 0.05 was considered statistically significant. Results: Out of 498 participants, 153 (30.7%) were aged between 31 and 40 years, 341 (68.5%) were female, 288 (57.8%) were married, and 266 (53.4%) had less than Diploma. Of the 498 participants, 351 (70.5%) experienced chronic stress. The protective factors against chronic stress were being married (AOR: 0.132; 95% CI: 0.043–0.408; p< 0.001), optimizing shift length (AOR: 0.056; 95% CI: 0.027–0.115; p< 0.001), religiosity/Spirituality (AOR: 2.750; 95% CI: 1.376–5.497; p= 0.004), and regular exercise and breaks (AOR: 0.405; 95% CI: 0.223–0.737; p= 0.003)
Exploring Effective Approaches: Integrating Mental Health Services into HIV Clinics in Northern Uganda
(HIV/AIDS - Research and Palliative Care, 2024) Kabunga, Amir; Namata, Halimah; Kigongo, Eustes; Musinguzi, Marvin; Tumwesigye, Raymond; Auma, Anna Grace; Nabaziwa, Jannat; Shikanga, Enos Mwirotsi; Okalo, Ponsiano; Nalwoga, Viola; Udho, Samson
Background: Integrating mental health services into HIV clinics is recognized as a promising strategy. However, the literature reveals gaps, particularly in the unique context of Northern Uganda, where factors such as historical conflict, stigma, and limited resources pose potential barriers. Material and Methods: This qualitative study, conducted between October and November 2023, employed a phenomenological design. The study involved primary healthcare facilities across diverse urban and rural settings, focusing on healthcare providers, village health teams, and service users. A purposive sampling approach ensured diverse demographics and perspectives. In-depth interviews and focus group discussions were conducted, with healthcare providers and service users participating individually, and village health teams engaged in group discussions. Thematic analysis was employed during data analysis. Results: Findings revealed a predominance of females among healthcare providers (18 of 30) and service users (16 of 25), as well as in VHTs. Average ages were 33.4 (healthcare providers), 38.5 (service users), and 35.1 (VHTs). Most healthcare providers (15) held diplomas, while 12 service users and 4 VHTs had certificates. The majority of healthcare providers (n=20) and 4 VHTs had 6–10 years of experience. Thematic analysis highlighted three key themes: benefits of integrated mental health services, implementation challenges, and the role of community engagement and cultural sensitivity. Conclusion: This study contributes valuable insights into the integration of mental health services into HIV clinics in Northern Uganda. The perceived benefits, challenges, and importance of cultural sensitivity and community engagement should guide future interventions, fostering a holistic approach that enhances the overall well-being of individuals living with HIV/AIDS in the region. Policymakers can use this information to advocate for resource allocation, training programs, and policy changes that support the integration of mental health services into HIV clinics in a way that addresses the identified challenges
Graduate Midwifery Education in Uganda Aiming to Improve Maternal and Newborn Health Outcomes
(Annals of Global Health, 2020) Kumakech, Edward; Anathan, Julie; Udho, Samson; Auma, Anna Grace; Atuhaire, Irene; Nsubuga, Allan G.; Ahaisibwe, Bonaventure
Background: Maternal and newborn health outcomes in Uganda have remained poor. The major challenge affecting the implementation of maternal and newborn interventions includes a shortage of skilled midwives. In 2013, Lira University, a Ugandan Public University, in partnership with Seed Global Health, started the first Bachelor of Science in Midwifery (BScM) in Uganda with a vision to develop a Master of Science in Midwifery (MScM) in the future. Objective: Evaluate results of Lira University’s Bachelors in Midwifery program to help inform the development of a Masters in Midwifery program, which would expand midwifery competencies in surgical obstetric and newborn care. Methods: Lira University and Ministry of Health records provided data on curriculum content, student enrollment and internships. The internship reports of the graduate midwives were reviewed to collect data on their employment and scope of practice. Interviews were also conducted with the graduates to confirm the added skills they were able to apply and their outcomes. Findings: The critical competences incorporated into the Bachelor in Midwifery curriculum included competences to care for pre- and post-operative caesarian section patients or assist in a caesarean section, newborn care (e.g. resuscitation from birth asphyxia), anesthesia, and theatre techniques, among others. Overall, 356 students (40.2% male, 59.8% female) enrolled in the BScM program over the period 2013–2018. Annual data shows an increasing trend in enrollment. Of the 32 graduates in January 2019, 87.6% were employed in maternal and newborn healthcare facilities, and 12.4% were employed in midwifery private practice. Follow-up interviews revealed that the graduate midwives reported positive maternal and newborn outcomes and the ability to practice advanced obstetrics and newborn care skills they acquired from the training. Conclusion: There is growing interest in a graduate midwifery education program in Uganda for both male and female students. The retention of the graduate midwives in healthcare facilities gives a renewed hope for mothers and newborns, who benefit from their extra obstetrics and newborn care competences in settings where there are neither medical doctors nor obstetricians and gynecologists. Recommendations: Further, larger tracer studies of the graduate midwives to identify the kinds of obstetric surgeries and newborn care services they ably performed and their corresponding maternal and newborn health outcomes is recommended. Also recommended is advocacy for recognition of extra skills of graduate midwives by health authorities in Uganda and the region.
Healthcare providers’ practice and attitude towards abortion service provision in Gulu city, Northern Uganda
(Research Square, 2020) Pebalo, Francis Pebolo; Auma, Anna Grace; Obol, James Henry
Background: Unsafe abortion is a growing public health problem concern globally despite being preventable. The World Health Organization estimates that about 20 million pregnancies results into unsafe abortion globally. The proportion of unsafe abortion has been increasing with developing countries contributing about 97% of unsafe abortions cases including Uganda. Unsafe abortion is among the four leading causes of pregnancy related mortality, injuries, and disability globally. The restrictive abortion laws and religious situation make abortion a highly controversial social issue in Uganda leading to high stigma in the society, and a majority of the healthcare providers are reluctant to perform an abortion even if indicated for fear of possible legal consequences. Methods: We conducted survey among health worker about knowledge of complications, practice, and attitudes of induced abortion between September and November 2019 among 252 healthcare providers in Gulu Municipality, Northern Uganda. Multivariate analysis showed associations between healthcare providers' characteristics and adequate knowledge about abortion complications. Ordinary least square regression analysis found associations between providers' characteristics and their intention for general support, generally not in support, conditional support for abortion provision, as well as their personal attitudes and beliefs against or towards abortion provision. Results: The mean attitudinal score for generally in support, generally not in support, conditional in support, personal attitude, and beliefs against and toward abortion provision were 2.80, 2.71, 2.86, 3.239, and 3.35 respectively. Participants who were married and practice Anglican religion were more likely to have good knowledge of abortion complications, p-values 0.035, and 0.042 respectively, meanwhile participants who were employed in faith-based facilities were more likely to have poor knowledge of abortion complications p-value 0.002. Conclusion: Ministry of Health and stakeholders need to provide training of health workers to improve quality of abortion services. Medical training institutions should ensure that students understand the laws and responsibilities that govern their professional actions with respect to abortion care regardless of their personal views, beliefs, and attitudes.
HIV-Related Stigma Among Pregnant Adolescents: A Qualitative Study of Patient Perspectives in Southwestern Uganda
(Taylor and Francis, 2024) Kabunga, Amir; Nabasirye, Caroline Kambugu; Kigingo, Eustes; Namata, Halimah; Shikanga, Enos Mwirotsi; Udho, Samson; Auma, Anna Grace; Nabaziwa, Jannat; Tumwesigye, Raymond; Musinguzi, Marvin; Okalo, Ponsiano; Acup, Walter
Background: The HIV epidemic disproportionately affects adolescents in Sub-Saharan Africa, with adolescent girls facing heightened vulnerability. Despite advancements in antiretroviral therapy, HIV-related stigma remains prevalent, particularly among pregnant adolescents. This qualitative study explores the perspectives of adolescents living with HIV in southwestern Uganda, seeking to understand the nature of HIV-related stigma in this context. Methods: One-on-one narrative interviews were conducted with 28 pregnant adolescents living with HIV aged 14–19 receiving care at Mbarara Regional Referral Hospital. The qualitative approach allowed for in-depth exploration of participants’ experiences. Thematic analysis was employed to identify recurring patterns in the narratives. Results: Five overarching themes emerged from the analysis: Experiences of double stigma, social and cultural influences shaping stigma, healthcare system challenges, psychosocial impacts of stigma, and resilience and coping mechanisms. Double stigma, arising from societal prejudices related to both HIV status and teenage pregnancy, created a complex environment for participants. Despite these challenges, participants exhibited resilience through external support and internal strength. Conclusion: This study reveals the pervasive double stigma experienced by pregnant adolescents living with HIV in southwestern Uganda, driven by societal biases against both HIV status and teenage pregnancy. Urgent targeted interventions are needed to address the intersectionality of stigma, cultural influences, healthcare issues, and psychosocial well-being for the betterment of this vulnerable population.
Intimate partner violence among pregnant teenagers in Lira district, northern Uganda: a cross-sectional study
(African Journal of Midwifery and Women's Health, 2020) Auma, Anna Grace; Ayebare, Elizabeth; Olwit, Connie; Ndeezi, Grace; Nankabirwa, Victoria; Tumwine, -James K
Background/aims Intimate partner violence during pregnancy is associated with adverse health outcomes for mothers and their unborn babies. Whereas the literature on intimate partner violence in the general population is extensive, little is known about this type of violence among pregnant teenagers, especially in resource-limited settings. This study aimed to determine the prevalence and factors associated with intimate partner violence among pregnant teenagers attending antenatal care clinics in Lira District, northern Uganda. Methods This was a cross-sectional study of 310 pregnant teenagers attending antenatal care clinics at the Lira Regional Referral Hospital and Ogur Health Center IV. Eligible teenagers were recruited consecutively until the required sample size was accrued. Data were collected using a structured questionnaire. Intimate partner violence was determined using the Revised Conflict Tactile Scale 2. Logistic regression analysis was performed to identify factors associated with violence during pregnancy, while considering potential confounding factors. Results The overall prevalence of intimate partner violence among pregnant teenagers was 40.6%. The prevalence of psychological violence was 37.1%, sexual assault was 29%, and physical violence was 24.8%. Partner alcohol intake (odds ratio=5.00, P=0.000); polygamy (odds ratio=2.80, P=0.001) and the inability of the teenage mother to make major decisions in the home (odds ratio=2.42, P=0.006) were independently associated with intimate partner violence during pregnancy. Conclusions Approximately 4 in 10 pregnant teenagers in Lira district, northern Uganda experienced intimate partner violence. This is higher than has been reported in the general population of pregnant women in Uganda. Intimate partner violence screening and counselling should be part of the routine antenatal care package.
Intimate partner violence among pregnant women in Uganda
(African Journal of Midwifery and Women’s Health, 2019) Epuitai, Joshua; Udho, Samson; Auma, Anna Grace; Nabirye, Rose Chalo
Background: Intimate partner violence may be more prevalent during pregnancy as women are more vulnerable. Aims: To determine the prevalence of intimate partner violence and associated factors among pregnant women at Soroti Regional Referral Hospital, Uganda. Methods: A cross-sectional study was conducted among 180 pregnant women. Data were collected using a pre-tested, semi-structured questionnaire. Intimate partner violence was measured using the revised Conflict Tactile Scale 2. Findings: The overall prevalence of intimate partner violence during pregnancy was 27.8%. Household average monthly income, experiences of intimate partner violence before pregnancy and marital conflicts were independently associated with intimate partner violence during pregnancy. Conclusions: Screening should be done during antenatal care among women with low household income, marital conflicts, and history of intimate partner violence before pregnancy to identify and manage cases of intimate partner violence. More research is needed to identify interventions for reduction of intimate partner violence during pregnancy.
Knowledge and Perceptions of men towardsVasectomy among men of reproductive age inOtuke District-a cross-sectional study
(Research square, 2024) Auma, Anna Grace; Madira, Emmanuel; Namukwana, Beth; Izaruku, Ronald; Kabunga, Amir; Wmicheal, Tamrat Endale
Objective: This study aimed to assess the knowledge and perceptions of vasectomy as a family planningmethod among men in rural northern Uganda. Methods: A cross-sectional study was conducted involving 624 participants. Sociodemographiccharacteristics, use of vasectomy, number of children, and knowledge of vasectomy were assessed.Perceptions of vasectomy were measured, focusing on cultural, religious, and gender-related aspects. Results: The study revealed a predominantly adult, married, and Catholic population with low educationalattainment. Only 2% of participants had undergone vasectomy, indicating limited utilization. Whileapproximately half demonstrated awareness of vasectomy, negative perceptions prevailed, with 63.5%expressing unfavorable opinions. Cultural and religious beliefs, along with concerns about promiscuity,played a signifi cant role in shaping negative perceptions. The majority believed in male dominance infamily planning decisions, and a considerable portion endorsed sterilization exclusively for women. Conclusion : This study highlights the low utilization and predominantly negative perceptions ofvasectomy among men in rural northern Uganda, emphasizing the need for targeted interventions toaddress cultural and religious misconceptions and enhance education on family planning options. Publichealth campaigns should focus on dispelling misconceptions about vasectomy, particularly addressingcultural and spiritual concerns. Educational programs should target men and their communities,emphasizing the benefi ts of shared family planning decisions. Further research incorporating qualitativemethods could provide a deeper understanding of the cultural aspects infl uencing vasectomyperceptions in this population.
Partograph Documentation: Barriers and Faciltators Among Skilled Health Personnel in Lamwo District, Northern Uganda
(Lira University, 2022) Lokwang, Paul Pax; Udho, Samson; Auma, Anna Grace
Background: Appropriate use of partograph is significantly associated with improved maternal and neonatal outcomes of labour and that is why the World Health Organization recommends its universal use during labour. However, the extent of partograph documentation and the barriers and facilitators to partograph documentation by skilled health personnel in Lamwo district is not well documented. This study aimed to assess the level of partograph documentation and explore the barriers and facilitators to partograph documentation by skilled health personnel in Lamwo district, northern Uganda. Methods: This was a parallel convergent mixed methods study conducted in 10 purposively sampled health facilities in Lamwo district. We retrospectively reviewed 328 randomly sampled partographs and conducted 18 key informant interviews and 8 Focused Group Discussions with purposively sampled skilled health personnel. The partographs were reviewed using a checklist while FGD and KII guides were used for FGDs and KIIs respectively. Quantitative data were analysed descriptively while qualitative data were analyzed thematically. Results: The overall documentation of partograph according to the WHO recommended standard was at 54.3% while maternal and fetal components of the partograph were documented at 58% and 95% respectively. The identified barriers to standard partograph documentation were heavy workload, lack of knowledge and skills, negative attitude, lack of equipment and supplies, and negative perception. The identified facilitators were being knowledgeable and skilled, adequate human resource, availability of equipment, supportive supervision, and a positive attitude. Conclusion: Standard partograph documentation by skilled health personnel in Lamwo district is still suboptimal owed to various factors. The ministry of Health and supporting partners should create an enabling environment and build capacity of skilled health personnel to strengthen Partograph documentation in the district.
Phenomenology of Induced Abortion in Northern Uganda Among HIV-Positive Women Following an Unintended Pregnancy
(Open Access Journal of Contraception, 2023) Kabunga, Amir; Acanga, Alfred; Akello, Judith Abal; Nabasirye, Caroline Kambugu; Namata, Halimah; Mwesigwa, David; Auma, Anna Grace; Kigongo, Eustes; Udho, Samson
Background: More than half of pregnancies in Uganda are unintended, and nearly a third of these end in abortion. However, little research has focused on women living with HIV’s subjective experiences following induced abortion. We explored how women living with HIV subjectively experience induced abortions in health facilities in Lira District, Uganda. Materials and Methods: This was a descriptive-phenomenological study between October and November 2022. The study was conducted among women of reproductive age (15–49 years) who were HIV positive and had undergone induced abortion following an unintended pregnancy. Purposive sampling was used to sample 30 participants who could speak to the research aims and have experience with the phenomenon under scrutiny. The principle of information power was used to estimate the sample size. We conducted face-to-face, in-depth interviews to collect data. Data were presented as direct quotes while providing a contextual understanding of the lived experiences of the study participants. Results: The results showed that the major causes of induced abortion were financial constraints, concern for the unborn babies, unplanned pregnancy, and complex relationships. Regarding induced abortion-related experiences, three themes emerged: loss of family support, internalized and perceived stigma, and feelings of guilt and regret. Conclusion: This study highlights the lived experiences of women living with HIV following an induced abortion. The study shows that women living with HIV had induced abortions due to numerous reasons, including financial concerns, complicated relationships, and a fear of infecting their unborn babies. However, after induced abortion, the women living with HIV faced several challenges like loss of family support, stigma, and feelings of guilt and regret. Based on HIV-infected women who underwent induced abortion and an unexpected pregnancy, they may need mental health services to reduce the stigma associated with induced abortion.
Polycystic ovarian syndrome: diagnostic challenges in resource-poor settings (Ugandan perspectives)
(PAMJ Clinical Medicine, 2021) Pebolo, Pebalo Francis; Auma, Anna Grace; Alobo, Gasthony
Polycystic ovarian syndrome is the most common cause of anovulatory infertility accounting for up to 40% of the reasons for visiting a doctor. The Ugandan government has recognized infertility as a major problem affecting over five million people, yet polycystic ovarian syndrome is not included in the Ugandan Clinical Guidelines, hence it´s not part of the Uganda minimum healthcare package. Lack of guidelines means diagnosis is a challenge and many cases have delayed or no diagnosis. Early diagnosis is good for awareness of associated risks such as infertility, dysfunctional uterine bleeding, endometrial cancer, obesity, diabetes, dyslipidemia, hypertension, and cardiovascular diseases. Clinical laboratories are handy in the diagnosis as well as follow-up of PCOS cases and in most rural settings, these are lacking, confounded by the lack of skilled frontline workers such as gynecologists and reproductive endocrinologists.
Qualitative study on stigma as a barrier to emergency contraceptive pill use among university students in the Lango subregion, Uganda
(BMJ Open, 2024) Kabunga, Amir; Kigongo, Eustes; Acanga, Alfred; Tumwesigye, Raymond; Auma, Anna Grace; Musinguzi, Marvin; Kambugu, Caroline Nabasirye; Okalo, Ponsiano; Akello, Judith Abal; Namata, Halimah; Mwesigwa, David
Objective The aim of the current study was twofold: to understand the nature and extent of stigma and to learn the reasons behind the decision not to use emergency contraceptive pills among university students in the Lango subregion of Uganda. Design An exploratory qualitative study design. Setting The study was carried out among university students in Lango subregion of Uganda. Participants 40 female university students across four universities. Main outcome measures Stigma. Results Participants (n=40) aged 19–26 exhibited generally positive attitudes towards emergency contraceptive pills, recognising them as empowering and essential. Stigma, however, emerged as a substantial barrier manifested in societal judgements and negative perceptions. Themes included the positive attitude towards emergency contraceptive pills, perceptions of peers and the general public, and perceptions of health service providers. Conclusion Stigma significantly impedes emergency contraceptive pill use among university students in the Lango subregion, Uganda. Positive attitudes towards the pills contrast with societal judgements and provider stigmatisation. Tailored interventions addressing knowledge gaps, societal perceptions and healthcare system challenges are crucial for improving emergency contraceptive pill acceptability and utilisation among university students.
A systematic review and meta-analysis of compassion fatigue among healthcare professionals before and during COVID-19 in Sub-Saharan Africa
(PLOS Glob Public Health, 2024) Kabunga, Amir; Kigongo, Eustes; Tumwesigye, Raymond; Udho, Samson; Musinguzi, Marvin; Acup, Walter; Auma, Anna Grace; Akello, Anne Ruth; Okalo, Ponsiano; Nabaziwa, Jannat; Shikanga, Enos Mwirotsi
Compassion fatigue is a significant concern globally, particularly in Sub-Saharan Africa, where the COVID-19 pandemic exacerbated existing challenges, placing unprecedented strain on healthcare professionals. This study systematically estimated the prevalence of compassion fatigue among healthcare professionals before and during COVID-19 in SubSaharan Africa. A systematic review was conducted using keywords in PubMed, ScienceDirect, Google Scholar, and grey literature, covering all literature published between 2012 and December 30, 2023. The search team independently conducted study selection, quality assessments, data extractions, and analysis of all included studies. The systematic review, reported following PRISMA guidelines, included 11 studies. The results show that the pooled overall prevalence of compassion fatigue in Sub-Saharan Africa was 70% (95% CI: 57–82, I 2 = 88.37%). The highest prevalence was found in Eastern Africa at 74% (95% CI: 55–93, I 2 = 94.40%), compared to 64% in Southern Africa (95% CI: 49–79, I 2 = 59.01%). Nurses reported the highest rates of compassion fatigue at 80% (95% CI: 57–100, I 2 = 34.77%), followed by general healthcare professionals at 59% (95% CI: 22–97, I 2 = 94.11%) and nursing students at 50% (95% CI: 35–64, I 2 = 0.00%). Before COVID-19, the overall prevalence of compassion fatigue was 66% (95% CI: 41–91, I 2 = 27%). During COVID-19, this increased to 74% (95% CI: 63–85, I 2 = 88.73%). Our results indicate that nearly 3 in 4 healthcare professionals in Sub-Saharan Africa experience compassion fatigue, and this prevalence increased due to the pandemic. The high prevalence underscores the importance of addressing and mitigating compassion fatigue to support the mental health and emotional well-being of healthcare professionals dedicated to helping others in challenging circumstances.
Systematic review and meta-analysis of postpartum depression and its associated factors among women before and after the COVID-19 pandemic in Uganda
(BMJ Open, 2024) Kabunga, Amir; Tumwesigye, Raymond; Kigongo, Eustes; Musinguzi, Marvin; Acup, Walter; Auma, Anna Grace
Objective This meta-analysis aimed to estimate the national prevalence of postpartum depression (PPD) in Uganda and identify predictors in both pre-COVID-19 and post-COVID-19 eras. Design Used a systematic review and meta-analysis methodology. Data sources Reviewed papers were sourced from Medline/PubMed, PsycINFO, CINAHL/EBSCOhost, Google Scholar, ScienceDirect and African Journals Online. Eligibility criteria for selected studies The review encompassed observational studies published on PPD in Uganda from 1 January 2000 to 30 November 2023. Results 11 studies (involving 7564 participants) published from 1 January 2000 to 30 November 2023 were reviewed. The pooled prevalence of PPD in Uganda was 29% (95% CI 21% to 37%, I2 =98.32%). Subgroup analysis indicated a similar prevalence before (29%, 95% CI 20% to 39%) and during (28%, 95% CI 22% to 32%) the COVID-19 period. Special groups exhibited a higher prevalence (32%, 95% CI 16% to 47%) than general postpartum women (28%, 95% CI 19% to 37%). Factors associated with PPD included poor social support (OR 1.19, 95% CI 1.17 to 1.22, I2 =96.8%), maternal illness (OR 1.22, 95% CI 1.19 to 1.26, I2 =96.9%), poor socioeconomic status (OR 1.43, 95% CI 1.40 to 1.46, I2 =99.5%) and undergoing caesarean section (OR 1.15, 95% CI 1.12 to 1.17, I2 =80.6%). Surprisingly, there was a marginal decrease in PPD during the COVID-19 period. Subgroup analysis highlighted a higher prevalence among mothers with HIV. Conclusion This study underscores the significant prevalence of PPD in Uganda, with sociodemographic factors increasing risk. Despite a slight decrease during the COVID-19 period, the importance of prioritising maternal mental health is emphasised, considering sociodemographic factors and pandemic challenges, to improve maternal and child health outcomes and overall well-being.
Utilization of antiretroviral therapy services and associated factors among adolescents living with HIV in northern Uganda: A cross-sectional study
(PLoS ONE, 2023) Odongo, Innocent; Arim, Barbara; Ayer, Patrick; Murungi, Tom; Akullo, Susan; Aceng, Docus; Oboke, Henry; Kumakech, Edward; Obua, Celestino; Auma, Anna Grace; Richard, Nyeko
Background Suboptimal utilization of antiretroviral therapy (ART) services remains a problem among adolescents in low- and middle-income countries, which has a negative impact on their response to treatment and increases the risk of developing resistance. Optimal use is essential to enhancing treatment efficacy. We investigated the optimal use of ART service and predictors among adolescents living with HIV (ALHIV) in northern Uganda. Methods We used a cross-sectional study design to collect quantitative data from 293 ALHIV at three health facilities in Lira municipality, northern Uganda. We used an interviewer-administered questionnaire and data abstraction form. Data were analysed using SPSS version 23 soft ware. Descriptive analysis and logistic regressions were performed to determine the relation ship between the predictor and outcome variables. Statistical significance was determined at P-value<0.05 and the adjusted odds ratio with a 95% confidence interval was used. Results The level of utilization of ART services was suboptimal among 27.6% (81/293) of the partici pants, and only 63.1% (185/293) were virally suppressed. Of the participants who were opti mally utilizing ART services, the majority 86.8% (184/212) were virally suppressed. Age 10– 14 years (aOR = 3.34), the presence of both parents (aOR = 1.85), parental and peer reminders (aOR = 2.91) and (aOR = 0.49) respectively, and being on ART for five years or less were the characteristics related with optimal utilization of ART services. Conclusions and recommendations Not all ALHIV used ART services to their full potential. However, factors such as partici pants’ age, the presence of both parents, reminders from parents and peers, and being on ART for some time were all related to the optimal use of ART services. There is a need for developing strategies to increase family and peer support with a focus on older adolescents if the 95-95-95 goal is to be achieved in this age group.
Utilization of antiretroviral therapy services and associated factors among adolescents living with HIV in northern Uganda: A crosssectional study
(PLoS ONE, 2023) Odongo, Innocent; Arim, Barbara; Ayer, Patrick; Murungi, Tom; Akullo, Susan; Aceng, Docus; Oboke, Henry; Kumakech, Edward; Obua, Celestino; Auma, Anna Grace; Nyeko, Richard
Background Suboptimal utilization of antiretroviral therapy (ART) services remains a problem among adolescents in low- and middle-income countries, which has a negative impact on their response to treatment and increases the risk of developing resistance. Optimal use is essential to enhancing treatment efficacy. We investigated the optimal use of ART service and predictors among adolescents living with HIV (ALHIV) in northern Uganda. Methods We used a cross-sectional study design to collect quantitative data from 293 ALHIV at three health facilities in Lira municipality, northern Uganda. We used an interviewer-administered questionnaire and data abstraction form. Data were analysed using SPSS version 23 software. Descriptive analysis and logistic regressions were performed to determine the relationship between the predictor and outcome variables. Statistical significance was determined at P-value<0.05 and the adjusted odds ratio with a 95% confidence interval was used. Results The level of utilization of ART services was suboptimal among 27.6% (81/293) of the participants, and only 63.1% (185/293) were virally suppressed. Of the participants who were optimally utilizing ART services, the majority 86.8% (184/212) were virally suppressed. Age 10– 14 years (aOR = 3.34), the presence of both parents (aOR = 1.85), parental and peer reminders (aOR = 2.91) and (aOR = 0.49) respectively, and being on ART for five years or less were the characteristics related with optimal utilization of ART services. Conclusions and recommendations Not all ALHIV used ART services to their full potential. However, factors such as participants’ age, the presence of both parents, reminders from parents and peers, and being on ART for some time were all related to the optimal use of ART services. There is a need for developing strategies to increase family and peer support with a focus on older adolescents if the 95-95-95 goal is to be achieved in this age group.

Browsing by Author "Auma, Anna Grace"

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