Browsing by Author "Musinguzi, Marvin"
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Item Access to family planning services and associated factors among young people in Lira city northern Uganda(BMC Public Health, 2024) Kigongo, Eustes; Tumwesigye, Raymond; Anyolitho, Maxson Kenneth; Musinguzi, Marvin; Kwizera, Gad; Achan, Everlyne; Nabasirye, Caroline Kambugu; Udho, Samson; Kabunga, Amir; Omech, BernardBackground Access to family planning services among young people is crucial for reproductive health. This study explores the access and associated factors among young people in Lira City, Northern Uganda. Methods and materials A mixed-methods study was conducted in March to April 2022. Quantitative data were collected using a structured questionnaire from 553 participants aged 15–24 years. Qualitative data were obtained through in-depth interviews and focus group discussions. Data analysis included univariate, bivariate, and multivariate analyses for quantitative data, while interpretative phenomenological analysis was used for qualitative data. Results Overall, 31.7% of the respondents had a good perceived access to family planning services, with 64.6% reporting perceived availability of FP methods. Challenges included lack of privacy (57.7%), fear of mistreatment (77.2%), and decision-making difficulties (66.2%). Among females, good perceived access to FP services was less likely among urban residents (AOR: 0.22, 95% CI: 0.09–0.53), Christian respondents (AOR: 0.51, 95% CI: 0.01–0.36), Muslim respondents (AOR: 0.07, 95% CI: 0.01–0.55) and respondents with poor attitude to FP services (AOR: 0.39, 95% CI: 0.24–0.64), but more likely among respondents with a sexual a partner (AOR: 4.48, 95% CI: 2.60–7.75). Among males, good perceived access to FP services was less likely among respondents living with parents (AOR: 0.19, 95% CI: 0.05–0.67) but more likely among respondents with good knowledge of FP services (AOR: 2.28, 95% CI: 1.02–5.32). Qualitative findings showed that three themes emerged; knowledge of family planning methods, beliefs about youth contraception and, friendliness of family planning services. Conclusion The study revealed a substantial gap in perceived access to family planning services among young people in Lira City. Barriers include privacy concerns, fear of mistreatment, and decision-making difficulties. Tailored interventions addressing urban access, religious beliefs for females, and knowledge enhancement for males are essential. Positive aspects like diverse FP methods and physical accessibility provide a foundation for targeted interventions. Youth-friendly services, comprehensive sexual education, and further research are emphasized for a nuanced understanding and effective interventions in Northern Uganda. Keywords Access, Contraception, Family planning, Youths, Young peopleItem 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, NamataBackground: 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.Item 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, HaliamaBackground: 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 careItem 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, HaliamaBackground 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.Item Chronic stress and its correlates among nurses: A case of Central Uganda(Avicenna J Neuro Psycho Physiology, 2023) Kabunga, Amir; Kigongo, Eustes; Udho, Samson; Musinguzi, Marvin; Tumwesigye, Raymond; Acup, WalterBackground: Despite an overwhelming disease burden, nursing shortages are evident in Sub-Saharan Africa, with the potential for significant healthcare crises. Nurses face increased work demands and chronic stress due to a skilled personnel shortage, which may lead to stress. The present study aimed to examine chronic stress and its correlates among nurses in central Uganda. Methods: The 12-item Short Form Survey (SF-12) for the assessment of chronic stress among nurses, a validated and standardized tool, was used in this cross-sectional study in 2022. For explanatory analysis, the items were combined with dichotomous variables reflecting predictors of chronic stress. These items were used to create dichotomous variables denoting frequent and demanding challenges for exploratory analysis. The relationship between the variables and high levels of chronic stress was investigated using a multivariate logistic regression model. Results: Based on the findings, the majority, 485 (76.0%), had chronic stress. The results indicate that the correlates of chronic stress among participants were widowhood (AOR: 0.040; 95% CI: 0.013-0.127; P= <0.001), being worried about looming deadlines (aOR: 0.003; 95% CI: 0.001-0.023; P = <0.001), long working hours (AOR: 0.283; 95% CI: 0.159-0.504; p=<0.001), insufficient job control (AOR: 0.304; 95% CI: 0.127-0.727; P = 0.007), and inadequate rewards (AOR: 2.554; 95% CI: 1.170-5.574; P = 0.019). Conclusion: According to our findings, three in four nurses in central Uganda suffer from chronic stress. This can exert a negative impact on their overall well-being and caring behaviors. Chronic stress was associated with widowhood, a looming deadline, long working hours, insufficient job control, and inadequate rewards. It is critical to adapt interventions, such as hiring additional nurses, to reduce workload and ensure adequate rest periods.Item Ebola Epidemic Preventive Practices: Knowledge, Attitude and Practice of Community Members in High-Risk Districts of Uganda(Journal of Infectious Diseases and Medicine, 2023) Kigongo*, Eustes; Auma, Ann Grace; Tumwesigye, Raymond; Namukwana, Beth; Musinguzi, Marvin; Okalo, Ponsiano; Kambugu, Caroline Nabasiry; Kabunga, AmirBackground: As part of the country's ongoing EVD outbreak preparedness activities in Uganda, our goal was to evaluate community knowledge and attitudes and preventive practices linked to the disease. Methods: This study employed a community-based cores sectional study among 842 participants. The study was conducted in three districts of Mubende, Kyegegwa and Kassanda in the central region of Uganda. These are high-risk districts in Uganda Results: Results show that the majority 290(34.4%) of the participants were aged between 28–38 years, 578(68.6%) were female, 482(57.2%) had primary education, 431(51.2) single, 369(44.7) unemployed and 196(23.8) received information from radios. Results indicate that 821(97.5%) of the participants had heard of EVD, and 646(76.7%) reported that EVD is a rare and deadly disease. On the mode of transmission, 562(66.7%) knew that EVD is transmitted through physical contact with an infected person, 498(59.1%) through blood and 606(72.0%) through normal social contact. Overall, 525 respondents were classified as having good knowledge of the Ebola virus disease, accounting for 62.4% of the total, whereas 470(55.8%) had a favorable attitude toward the management and prevention of the Ebola virus disease. A greater understanding of the Ebola virus disease was found among participants with increased age and education beyond the first grade compared to those with no formal education. Casual labourers were 3 times more likely to have good practices compared to agriculturalists. Participants who received information from others sources were less likely to have good practices compared to those who received it from the radio. Conclusion: Communities in Uganda impacted by filovirus outbreaks have a reasonable level of knowledge and a favourable attitude toward methods to prevent and control the Ebola disease. Public health officials should do more by providing instructional materials for future epidemic preparedness utilizing appropriate communication channels, especially, including local radios as reported by the communities. Keywords: Attitude • Ebola virus • Infection • Knowledge • PreventionItem Enhancing Mental Health Counseling for Education Professionals in Africa: Addressing Unique Needs and Improving Outcomes(B P International, 2024) Kabunga, Amir; Nalwoga, Viola; Kigongo, Eustes; Anyolitho, Maxson Kenneth; Musinguzi, Marvin; Okalo, Ponsiano; Shikanga, Enos MwirotsiIn the vibrant and varied educational landscapes of Africa, the voices of resilience, dedication, and passion often overshadow the quieter, yet significant, struggles faced by those who shape our future: the education professionals. As we delve into “Enhancing Mental Health Counseling for Education Professionals in Africa: Addressing Unique Needs and Improving Outcomes,” we approach this endeavor with profound respect and commitment to the well-being of those who nurture the minds of tomorrow. Education professionals hold a critical role in shaping both the intellectual and emotional development of the next generation. Their unwavering commitment to education lays the groundwork for a better future. However, in the pursuit of academic excellence, their own mental health often remains neglected. This book aims to shed light on the critical intersection of mental health and education, specifically addressing the unique challenges encountered by educators across the diverse African continent. Throughout these pages, we delve into the cultural and contextual factors that influence the experiences of education professionals in Africa. We emphasize that the well-being of educators is intrinsically linked to the health and effectiveness of the educational systems they support. By examining mental health counseling as a transformative tool, we highlight its potential to build resilience, promote self-care, and enhance overall professional satisfaction. This book is more than an academic exploration; it is a call to action. We urge educational institutions, policymakers, and communities to prioritize the mental health of their educators. We advocate for a shift in perspective, encouraging the creation of environments where seeking mental health support is seen not as a weakness but as a reflection of the strength and dedication inherent in the teaching profession. As we address the nuanced issues of mental health counseling tailored to the African educational context, we hope this book will serve as a comprehensive guide, a source of inspiration, and a catalyst for positive change. It is our aspiration that this work will elevate the conversation around the mental well-being of education professionals and place it at the center of educational discourse. In our shared quest for educational excellence, let us remember that the well-being of those who facilitate learning is a fundamental pillar. Together, let us embark on a transformative journey to create nurturing and supportive environments for the individuals who are shaping the minds of the future. Keywords: Mental health counseling, education professionals, Africa, cultural sensitivity, resilience in education, and traditional practices in counselingItem 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, SamsonBackground: 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 challengesItem Factors associated with first antenatal care (ANC) attendance within 12 weeks of pregnancy among women in Lira City, Northern Uganda: a facility-based cross- sectional study(BMJ, 2023) Acup, Walter; Opollo, Marc Sam; Akullo, Betty Nancy; Musinguzi, Marvin; Kigongo, Eustes; Opio, Bosco; Kabunga, AmirObjective This study aimed at assessing factors associated with first antenatal care (ANC) attendance within 12 weeks of pregnancy among women in Lira City. Design A cross-sectional study. Settings The study was conducted in health facilities offering ANC services in Lira City, Northern Uganda. Participants The study was among 368 pregnant mothers attending their first ANC in the three selected facilities (Lira Regional Referral Hospital, Ober Health Center IV and Pentecostal Assembly of God Mission Health Center IV) in Lira City. Primary and secondary outcome measures Level of first ANC attendance within 12 weeks of pregnancy and associated factors. Results Early ANC attendance was 36.1%. Women who were: unmarried (adjusted OR (aOR): 0.40, 95% CI: 0.16 to 0.99), took >2 hours to reach a health facility (aOR: 0.21, 95% CI: 0.07 to 0.62), or not visited by village health teams or healthcare workers at home (aOR: 0.33, 95% CI: 0.12 to 0.92) were less likely to attend their first ANC early. On the other hand, women who were: not knowing first that ANC guides parents on infant care (aOR: 2.22, 95% CI: 1.06 to 4.67); pregnant without consent of spouse (aOR: 4.29, 95% CI: 1.75 to 10.55); attending ANC from a private facility (aOR: 2.89, 95% CI: 1.27 to 6.15); and having two to three healthcare workers present at the ANC clinic (aOR: 1.79, 95% CI: 1.03 to 3.13) were more likely to attend ANC early. Conclusions Despite the fact that the WHO recommends that all women begin ANC within 12 weeks after conception, Lira City in Northern Uganda had a low overall incidence of timely ANC initiation. Being unmarried, distance to reach a health facility, and being visited by village health teams or healthcare workers at home were all linked to timely ANC commencement. As a result, intervention efforts should concentrate on the highlighted determinants in order to promote ANC initiation in Lira City, Northern Uganda. This can be accomplished by providing information and education to the community on the timing and necessity of ANC in Northern Uganda.Item Female-controlled dual protection methods: Prevalence, predictors, experiences and perceptions among young women living with HIV in northern Uganda–A mixed-method study protocol(PLoS ONE, 2023) Kumakech, Edward; Acen, Joy; Musinguzi, Marvin; Ebong, Doryn; Okello, JamesStudy background The use of dual protection methods among young women living with HIV (YWLHIV) aged 15–24 years in sub-Saharan Africa (SSA) is poorly researched despite the double risk of unintended pregnancy and HIV. Even more scanty is literature on the use of female-controlled dual protection methods. We propose to determine the female-controlled dual protection prevalence, and the predictors among YWLHIV in northern Uganda. The study will also explore the YWLHIV’s experiences and perceptions regarding the female-controlled dual protection methods. Materials and methods This study will employ a mixed-methods design. The study area will be Lira district and Lira city located in northern Uganda. The setting for recruitment of participants will be the public health facility–based anti-retroviral therapy (ART) clinics. These ART clinics serves a total of about 1,771 YWLHIV. A sample of 425 YWLHIV will be selected by stratified random sampling from the ART clinic registers. The three strata of interest will be the YWLHIV attending the ART clinic at referral hospitals, health centers level IV (primary healthcare centers), and health centers level III (dispensaries). The primary outcome will be the use of the femalecontrolled dual protection methods. The outcome will be measured by asking the YWLHIV ‘what methods under their control as YWLHIV do they use to protect against both unintended pregnancy and HIV during sexual intercourse with their male partners.’ The questionnaire also has measures for the unintended pregnancy, HIV status, and the potential predictors. Qualitative component of the study will be in-depth interviews of the participants about their experiences and perceptions regarding the female-controlled dual protection. methods. Data collection was still ongoing at the time of first submission of this study protocol to the journal (14th March 2023). The Statistical Package for Social Sciences (SPSS) version 23.0 will be used for the statistical analyses. Descriptive statistics, bivariate and multivariate regression analyses will be used to establish the prevalence, associated factors and the predictors of the outcome respectively. The statistical significance level of 5% and 95% confidence interval will be considered. In-depth interviews will be manually analyzed using a thematic analysis approach for codes, themes, and categories.Item 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, WalterBackground: 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.Item Medical Waste Management Practices and Associated Factors Among Health Workers in Public Health Facilities Within Lira City, Northern Uganda(Lira University, 2023) Okii, Richard; Akech, Stella Immaculate; Musinguzi, MarvinBackground: According to research done at Lira Regional Referral Hospital (LRRH), only 56 percent of medical professionals appropriately manage medical waste. If not appropriately disposed of, these wastes can cause major health risks to health workers and communities, including injuries, infections, trauma, wounds, and environmental contamination. The objective was: To examine the medical waste management practices and associated factors among health workers in public health facilities in Lira City, Northern Uganda. Methods: This was a cross-sectional study conducted in public health facilities in Lira City in July, 2023. The study population was health workers and the sample size of 200 was determined using the Yamane formula (1967). Simple random sampling and a structured questionnaire were used to collect the data. Data were entered in SPSS version 23 and further analyzed in STATA version 15 at three levels including univariate (descriptive statistics), bivariate (cross tabulations X2), and multivariate level (multivariate logistic regression). Ethical approval was obtained from Lira University Research and Ethics Committee (LUREC) and the ethical considerations were observed during data collection. Results: Just over one-quarter (28.5%) of the health workers in public health facilities had good practices towards medical waste management. The predictors of good medical waste management practices included having knowledge about medical waste disposal (AOR=1.53, p=0.021, 95% CI 0.44-5.4), and occupation (AOR=2.757, p=0.04, CI 0.94-4.12) Conclusion: There are poor medical waste management practices in facilities in Lira City. We recommend that the government of Uganda should provide enough supplies to the facilities, City Health Authorities should conduct continuous medical education for the workers, and there should be supervision of health workers to ensure proper management of medical waste. Keywords: Medical Waste, Health Workers, Public Health FacilitiesItem Prevalence and correlates of teenage pregnancy among in-school teenagers during the COVID-19 pandemic in Hoima district western Uganda–A cross sectional community-based study(PLoS ONE, 2022) Musinguzi, Marvin; Kumakech, Edward; Auma, Anne Grace; Akello, Ruth Anne; Kigongo, Eustes; Tumwesigye, Raymond; Opio, Bosco; Kabunga, Amir; Omech, BernardBackground The COVID-19 pandemic related restrictions and lockdown measures had compromised the routine delivery and access of sexual and reproductive health and rights services to the population including the teenage girls. However, the teenage pregnancy rates during COVID-19 pandemic period were poorly documented. This study aimed at determining the prevalence and the factors associated with teenage pregnancy among in-school teenage girls during the COVID-19 pandemic period in Hoima District Uganda. Methods This was a descriptive cross-sectional study that employed quantitative research methods. A total of 314 in-school teenage girls aged 13–19 years were selected using a multi-stage sampling techniques. Interviewer-administered questionnaires were used to collect the data from the participant’s homes during the period December 2021-January 2022. Data analysis was done using univariate, bi-variate, and multivariate. Results The prevalence of teenage pregnancy among the in-school teenage girls in Hoima district Uganda was 30.6% [96/314]. Higher teenage pregnancy rates were prevalent among the unmarried teenage girls [aOR: 9.6; 95%CI: 4.64–19.87; p = 0.000], teenage girls studying from boarding schools [aOR 2.83, 95%CI 1.36–5.86, p = 0.005], contraceptive non-users [aOR: 2.54; 95%CI: 1.12–5.4; p = 0.015] and teenage girls involved in sex trade [aOR 3.16, 95%CI 1.5–6.7, p = 0.003]. The factors associated with the reduced likelihood for teenage pregnancy included being an adult teenage girl aged 18–19 years [aOR: 0.15; 95%CI: 0.07–0.32; p = 0.000] and not receiving sex education during the period [aOR 0.36, 95%CI 0.13– 0.62, p = 0.024]. Conclusion The results indicated that 3 out of 10 in-school teenage girls from Hoima district Uganda got pregnant during the COVID-19 pandemic period of 2021. Teenage pregnancy was prevalent among teenage girls who don’t use modern contraceptive methods and those involved in sex trade. Teenage pregnancy was however, less prevalent among adult teenage girls aged 18–19 years. The findings point to the need for health stakeholders to innovate creative policies, contingency plans and programmes aimed at delaying age for sexual activities, increasing contraceptive use and minimizing pregnancy risk from sex trade among in-school teenage girls during COVID-19 pandemics.Item Prevalence and predictors of COVID-19 vaccination hesitancy among healthcare workers in Sub-Saharan Africa: A systematic review and meta-analysis(PLOS ONE, 2023) Kigongo, Eustes; Kabunga, Amir; Tumwesigye, Raymond; Musinguzi, Marvin; Izaruku, Ronald; Acup, WalterBackground The COVID-19 vaccination is regarded as an effective intervention for controlling the pan demic. However, COVID-19 vaccine hesitancy is hampering efforts geared towards reduc ing the burden of the pandemic. Therefore, examining COVID-19 hesitancy and its predictors among healthcare workers is essential to improving COVID-19 uptake. In sub Saharan Africa, the pooled proportion of COVID-19 vaccine hesitancy is yet to be known. Purpose The present study was to estimate the pooled proportion of COVID-19 vaccine hesitancy and its predictors among healthcare workers in Sub-Saharan Africa. Methods A systematic search of articles was conducted in PubMed, Science Direct, African Journal Online, and Google Scholar. Data was extracted with the help of Excel. Data analysis was conducted using STATA 17. Heterogeneity in the studies was assessed using Cochrane Q and 12 tests. A random effects model was used to examine the pooled estimates to deter mine if heterogeneity was exhibited. Results A total of 15 studies involving 7498 participants were included in the final analysis. The pooled prevalence of COVID-19 vaccination hesitancy among healthcare workers was 46%, 95% CI (0.38–0.54). The predictors of COVID-19 hesitancy were negative beliefs towards vaccine 14.0% (OR = 1.05, 95% CI: 1.04, 1.06), perceived low risk of COVID-19 infection 24.0% (OR = 1.25, 95% CI: 1.23, 1.28), and vaccine side effects 25.0% (OR = 1.23, 95% CI: 1.21, 1.24). Conclusion The data revealed generally high hesitancy of COVID-19 vaccine among health workers in Sub-Saharan Africa. Future COVID-19 adoption and uptake should be improved by national and individual level efforts. In Sub-Saharan Africa, it is crucial to address the myths and obstacles preventing healthcare professionals from accepting the COVID-19 vaccination as soon as feasible since their willingness to get the vaccine serves as an important example for the broader public.Item 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, DavidObjective 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.Item 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 MwirotsiCompassion 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.Item 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 GraceObjective 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.Item A Systematic Review and Meta-analysis of the Prevalence of Depression among Breast Cancer Patients in Sub-Saharan Africa(Avicenna Journal of Neuropsychophysiology, 2023) Kabunga, Amir; Kigongo, Eustes; Musinguzi, Marvin; Tumwesigye, Raymond; Acup, WalterBackground: Breast cancer is linked to neuropsychiatric conditions, particularly depression, which lowers life expectancy. Studies from Sub-Saharan Africa, however, have revealed conflicting prevalence rates of depression. Objective: To assess the combined prevalence of breast cancer-related depression among patients in Sub-Saharan Africa. Methods: The following search terms—depression, depressive disorders, breast cancer, mammary cancer, mammary adenocarcinoma and breast carcinoma, and Sub-Saharan African—were used to conduct a systematic search for English articles on depression published in PubMed, Scopus, Web of Science, African Journal Online, and Google Scholar. A meta-command was used to combine the results of different studies on depression linked to breast cancer through a random effects model at a 95% confidence interval in Stata software (version 17). Results: After the elimination of duplicates, 9,272 articles were still found after the electronic search yielded 12051 results. A number of 19 articles were still available after abstract and title screening, and they underwent full-text screening. A number of 10 articles were removed for a variety of reasons, including the lack of the full text (n=2), incorrect publication type (n=2), and not reporting the full outcome of interest (n=6). In Sub-Saharan Africa, the combined prevalence of breast cancer patients was 60%. (95CI, 0.51-0.69). The prevalence rates of depression among breast cancer patients in East Africa, South Africa, and West Africa were reported as 64% (95CI, 0.51-0.75), 60% (95CI, 0.53-0.67), and 55%. (95CI, 0.36-0.73), respectively. Conclusion: In Sub-Saharan Africa, about 6 in 10 cancer patients experience depression. Since depression negatively affects the quality of life, it is important to properly diagnose depression in order to treat it effectively with the fewest possible side effects. Keywords: Breast cancer, Depression, Depressive disorders, Neuropsychiatric disorderItem A systematic review and meta-analysis of the prevalence of depression among breast cancer patients in Sub-Saharan Africa(Avicenna Journal of Neuro Psycho Physiology, 2023) Kabunga, Amir; Kigongo, Eustes; Musinguzi, Marvin; Tumwesigye, Raymond; Acup, WalterBackground: Breast cancer is linked to neuropsychiatric conditions, particularly depression, which lowers life expectancy. Studies from Sub-Saharan Africa, however, have revealed conflicting prevalence rates of depression. Objective: To assess the combined prevalence of breast cancer-related depression among patients in Sub-Saharan Africa. Methods: The following search terms—depression, depressive disorders, breast cancer, mammary cancer, mammary adenocarcinoma and breast carcinoma, and Sub-Saharan African—were used to conduct a systematic search for English articles on depression published in PubMed, Scopus, Web of Science, African Journal Online, and Google Scholar. A meta-command was used to combine the results of different studies on depression linked to breast cancer through a random effects model at a 95% confidence interval in Stata software (version 17). Results: After the elimination of duplicates, 9,272 articles were still found after the electronic search yielded 12051 results. A number of 19 articles were still available after abstract and title screening, and they underwent full-text screening. A number of 10 articles were removed for a variety of reasons, including the lack of the full text (n=2), incorrect publication type (n=2), and not reporting the full outcome of interest (n=6). In Sub-Saharan Africa, the combined prevalence of breast cancer patients was 60%. (95CI, 0.51-0.69). The prevalence rates of depression among breast cancer patients in East Africa, South Africa, and West Africa were reported as 64% (95CI, 0.51-0.75), 60% (95CI, 0.53-0.67), and 55%. (95CI, 0.36-0.73), respectively. Conclusion: In Sub-Saharan Africa, about 6 in 10 cancer patients experience depression. Since depression negatively affects the quality of life, it is important to properly diagnose depression in order to treat it effectively with the fewest possible side effects. Keywords: Breast cancer, Depression, Depressive disorders, Neuropsychiatric disorderItem Uptake and Associated Factors of Male Contraceptive Method Use: A Community-Based Cross-Sectional Study in Northern Uganda(Open Access Journal of Contraception, 2023) Tumwesigye, Raymond; Kigongo, Eustes; Nakiganga, Stella; Mbyariyehe, Godfred; Nabeshya, Joel; Kabunga, Amir; Musinguzi, Marvin; Migisha, RichardBackground: Uganda has one of the highest fertility rates in Sub-Saharan Africa (SSA). Improving contraceptive uptake in all genders, including males, may be critical to meeting family planning goals in such a setting. Yet, data on male contraception uptake and associated factors in SSA, including Uganda, are limited. We determined the uptake and associated factors of male contraception use in Lira City, Northern Uganda. Methods: We conducted a community-based cross-sectional study from November 12, 2022, to December 12, 2022, among men aged ≥18 years. We used multi-stage sampling to select participants from 12 cells of Lira City divisions of East and West. Data were collected using interviewer-administered structured questionnaires. We defined uptake in males who had used any contraceptive method, including periodic abstinence, withdrawal, condoms, and vasectomy in the previous four weeks. We performed modified Poisson regression to identify associated factors of male contraception uptake. Results: We recruited 401 participants with mean age of 30.4 (±9.3) years. Male contraceptive uptake was 46.4%, 95% CI: 41.5– 51.3%. Ever heard about male contraception (adjusted prevalence ratio [aPR] =1.73, 95% CI: 1.172–2.539, p=0.006), willingness to use novel methods (aPR=2.90, 95% CI: 1.337–6.293, p=0.007), both partners being responsible for contraception (aPR: 1.53, 95% CI: 1.113–2.119, p=0.009) were the factors associated with male contraception uptake. Conclusion: We found that nearly half of the men surveyed had used male contraceptive methods in Lira City. Factors associated with the uptake of male contraception included having heard about male contraception, joint couple decision regarding contraception, and the use of novel methods of male contraception. We recommend comprehensive education and awareness campaigns to promote male contraception, with a particular emphasis on encouraging shared decision-making within couples and introducing innovative contraceptive options.