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Knowledge and Practices of Health Workers Towards Injuries due to Sharps in Health Facilitities and Access to HIV Post Exposure Prophylaxis in Nakaseke District, Uganda.
(International Health Sciences University, 2010-09) Ddamulira, Christopher
The study aimed at assessing health workers knowledge and practices related to sharp injury prevention, and access to post exposure prophylaxis against HIV, so as to generate information that will be used by the DHT to strengthen occupational HIV exposure control programs in health units. In Uganda, there is a high prevalence of sharp object injuries (57%) among health workers (M.O.H, 2003). 82.9% of the health workers in Semuto Health Centre IV in Nakaseke district had been exposed to potentially infectious fluids, this was mostly after percutenious injury and only 16.7% of these sought advice for PEP, despite the services being available in the two hospitals within the district (Nakaseke District HIV Monitoring and Evaluation Report, 2009). The study was carried out in Nakaseke district on facility based health workers offering clinical care; cleaners were included, because their work involves handling and disposing of used infectious sharp objects. The study was conducted between July and August 2011. It was a cross-sectional study that employed both quantitative and qualitative methods of data collection. Quantitative data was analyzed using EpiInfo 3.3 version and Microsoft Excel 2007 statistical packages. Univariate, Bivariate and Multivariate levels of data analysis techniques were applied. The major findings of the study were: Over fifty six percent (56.2%) of health workers in Nakaseke district had ever experienced sharp injuries; most of the health workers that experienced sharp injuries (66.1%) were nurses/midwives, followed by nursing assistants (61.0%). The majority of health workers (91.8%) who were injured did not seek PEP despite the ART and PEP of HIV services being available in the two hospitals in the district. Nurses/midwives and nursing assistants were respectively found to be 4.3 and 19.6 times respectively more likely to be injured by sharps compared to medical officers, and the commonest types of sharp related injuries (76.0%) were caused by needle stick and they occurred mainly when giving an injection (39.0%) followed by putting up an IV line (25.8%). Basing on the findings, the study recommended: Disseminate information regarding prevention of needle stick injuries and appropriate action following a high HIV risk needle stick injuries by HIV/AIDS specialists; and the emphasis should be in terms of risk management, teaching and continuing professional education. The Ministry of Health through the office of the District Health Officer should build the capacity of health centre IIIs and IVs in the districts to offer post exposure prophylaxis of HIV in order to increase the up take of PEP by health workers after exposure to high HIV risk needle stick injuries. The District Health Officer-Nakaseke should ensure that policies are in place on exposure control and PEP against HIV procedures are in all health units in the district to reduce the risk of occupational exposure to sharp injuries and increase up take of PEP against HIV. Further research to assess the impact of HIV infection among health workers as result of injuries due to sharps is recommended.
Depression,Anxiety and Self Esteem in Relation with Sleep Patterns Among Teenage Students :
(International Health Sciences University, 2010-09) Ssesanga, Denis Ernest
The purpose of this study was to investigate depression,anxiety and self esteem in relation with sleep patterns among teenage students. A total of 100 teenage students were selected to take part in this study. It was carried out at two schools namely; Green Hill Academy and Muyenga High School. Teenage students who are depressed may show loss of interest, feelings of low self worth, have disturbed sleep and poor concentration. The study inculcates all those in authority, parents and concerned citizens about why we should be concerned about the teenage students´ sleep patterns. We should know that sleep affects a teenage student´s depression,anxiety and self esteem. Eighty seven percent slept less than the recommended 8 hours per night while sixty eight percent slept for less than six hours per night on average seven percent of the students probably had severe depression. Fifty percent of students probably had very low anxiety compared to fifteen percent who had severe anxiety. Eighty seven percent of the students had very good self esteem compared to the thirteen percent who had low levels. The null hypothesis that stated that there was no significant relationship between self esteem and sleep patterns was rejected thus concluding that there is significant relationship between self esteem and sleep patterns among teenage students. Looking at how many students had moderate scores, on all the variables especially for sleep patterns and depression, there is a possibility that in the next ten years, the majority of students will have severe conditions if no precautions are undertaken by those in authority.
Injury Morbidity Patterns, Risk Factors and Facilities Attended After Injury in Makindye Division Kampala
(International Health Sciences University, 2011-08) Aboka, Willy Were
Background: There is paucity of injury-related data in Uganda. We conducted a population-based survey on injuries in Namuwongo suburb of Kampala. Objectives: We assessed the patterns of injuries that were sustained among Namuwongo communities between April and September of 2011, the associated factors and facilities that were attended for care. Methods: In a cross-sectional survey quantitative data from 144 households were collected using a questionnaire. Qualitative data were collected by focus group discussions in 3 of 6 participating zones and key informant interviews with community leaders and health facility managers. Results: Ninety-three injuries were reported among 653 subjects in 6 months. Major causes of injuries were road traffic accidents—RTA (24%), cuts (22%) and falls (17%). The mean age of injured people was 33 years (S.D. 12, range 0-67 years), males were more likely to get injured than females (OR: 1.69 CI: 1.05-2.7). 22% of subjects who reported injuries were housewives, 20% were students and 12% were motorcycle riders. Most injuries occurred in the home (54%), roads (27%) and schools (7%). Only 4% of subjects who sought care reported to the local public health facility; 96% sought care at private clinics and hospitals. There were no community-based injury services. Conclusions: RTA, falls and cuts were the commonest injury causes. Males and some occupations were more affected than others. Kampala City Authority needs to improve injury care services at peripheral units and in communities. A division-wide injury survey including cost analysis would inform policy development and advocacy for injury services. Number of words: 249. Key words: Injuries, Population-based, Uganda
Factors Influencing the Prevalence of Gender Based Violence Among Married Women in West Budama County, Tororo District.
(International Health Sciences University, 2011-09) Lynette, Opendi
The study sought to determine factors influencing the prevalence of gender based violence among married women in West Budama County, Tororo District. This was a descriptive cross sectional study. Cluster sampling was used for the quantitative study while purposive sampling was employed for the qualitative study. Pre-tested questionnaires and interview guides were used for data collection. The study was carried out between August and September 2011. The study found that the prevalence of GBV among married women in West Budama County was 85.4%. The types of GBV suffered by the married women include physical (about 29.9%), psychological abuse (about 30%) and sexual abuse (about 40%). Socio-demographic factors influencing GBV among married women was age, low education level, religion and occupation. Other factors influencing GBV among married women in West Budama County, Tororo include polygamy, alcohol and substance abuse, cultural practises such as the payment of bride price and widow inheritance. In conclusion, the prevalence of GBV among married women in West Budama County, Tororo District is high. The types of GBV suffered by the women are physical, sexual and psychological abuse. Factors influencing GBV are low education level, polygamy, alcohol and substance abuse, cultural practises like the payment of bride price and widow inheritance among others. The practise of payment of bride price and its influence on GBV needs to be researched among a bigger study population that includes even men. Further studies on GBV should be analytical to provide information on which variables predict GBV among married women.
Performance of Village Health Teams :
(International Health Sciences University, 2011-09) Adoa, John Steven
This study was about establishing the factors that influence the performance of Village Health Teams in Soroti District. The main objective of the study was to establish factors that influence the performance of the Village Health Teams in Soroti and to suggest measures that can be used to address these factors. The specific objectives of the study were: To examine the current motivational factors for the VHTs in Soroti District, to assess the current educational levels of VHTs in the District, to assess the current levels of skills and knowledge among VHTs in the District, to assess the level of training of VHTs and to assess the level of support supervision and mentoring of VHTs by the District and sub county health officials and also assess the level of performance of VHTs in Soroti District. Methodology: This was a cross sectional survey carried out in the District of Soroti covering the seven sub counties and the study sample population size was 175. Results: The study findings revealed that lack of motivation (provision of incentives), inadequate support supervision and lack of transport were identified as the key factors influencing the performance of VHTs in Soroti District. Conclusion: The study concluded that lack of motivation; support supervision and mentoring and inadequate transport have a significant influence on the performance of the VHTs in Soroti District. Recommendation: The study recommends implementation of a sustainable motivation mechanism, provision of regular support supervision and mentoring and provision of transport to VHTs as among the important measures that should be put in place to improve on their performance and consequently contribute to improvement of the health services delivery in Soroti District by the VHTs. And also further studies should be conducted on community’s attitudes and perceptions.
A study of Factors Affecting Cervical Cancer Screening Uptake Among Women Aged 20 to 60 Years.
(International Health Sciences University, 2011-09) Arineitwe, Ronald Kibonire
This study was done in Hoima district to determine the socio-demographic, clients’ and institutional factors affecting cervical cancer screening uptake among women aged 20 to 60 years so as to improve early detection as a way of reducing morbidity and mortality associated with this disease. The research questions that guided the study were as follows: What are socio-demographic factors affecting cervical cancer screening uptake among women in the age group of 20-60 years in Hoima district? What are the clients’ factors affecting the uptake of cervical cancer screening services among women in the age group of 20-60 years? What are the institutional factors affecting cervical cancer screening uptake among women of the age group 20 to 60 years? The study population consisted of 400 women aged between 20 to 60 years and 95 health workers as key informants from Hoima district from the 20 selected health centre III, IV and a Hospital. A cross-sectional study with quantitative method was carried out using interviewer administered semi-structured questionnaires. The key study findings were that socio-demographic such as age and marital status and occupation affect the uptake of cervical cancer screening in Hoima while the only clients’ factor that was significant was being told about the importance of cervical cancer screening. Availability of cervical cancer screening services were also found to be very limited only to one health facility(Reproductive Health Uganda Health centre) in the whole district and the uptake of screening services were generally low at only (3%) which is surprising considering how deadly this disease is . The study recommended the introduction of health promotion campaigns specific for cervical cancer emphasizing the importance of screening. It also recommended the introduction of cervical cancer screening services in all health centre 111s, IVs and a Hospital after training of at least two health workers (any of these: Nurses, midwives, clinical officers and doctors) from each of these health in Hoima district and equipping of these health facilities with acetic acid for screening since it is assumed that the other required equipments are already available.
Prevalence and Factors Associated with Adherence to Clinic Appointments of HIV Positive Patients Attending Joint Clinical Research Centre-Lubowa, Wakiso District.
(International Health Sciences University, 2011-09) Twikirize, Maureen
HIV/AIDS is still a serious problem world over. Many HIV positive people worldwide have been started on highly active anti-retroviral treatment (HAART) which has improved the quality of life. Although HAART has improved the quality of life and reduced the incidence of AIDS defining illnesses, some patients gradually stop honouring clinic appointments. A crossectional study to determine prevalence and factors associated with adherence to clinic appointments was done at JCRC –Lubowa,Wakiso district. The number of participants interviewed was 377, 64.2% were female, while 35.8% were male of mean age 41.9 years (SD=9.51), age range of 20 -75years. Objective: To determine the prevalence and factors associated with adherence to clinic appointments among patients attending JCRC adult OPD clinic. Methods: The study design was crossectional, and quantitative in nature. Structured questionnaires and interviews were used in collecting data, from HIV positive patients who had attended JCRC in the last one year. Other data like CD4 count was obtained from the Patient Care Research Database. Results: The proportion of JCRC patients who have missed schedule appointments in the last one year is 37.14%. Majority 94(25.07%) had missed at least one scheduled visit, while 28(7.47%) had missed more than three visits in the last one year. The prevalence of bad adherence to clinic appointments at Joint clinical Research Centre was found to be 37%, while that of good adherence was at 62.7% in patients who have been attending JCRC adult out patient clinic in the last one year. Factors associated with adherence to clinic appointment were; fair quality of health services at JCRC, current performance scale of between I –II, current CD4 count of greater than 350cells/microlitre, a higher level of education (Secondary and university level) and means of transport. Significance of the study: Conducting this study has helped to determine the prevalence and factors such as means of transport, performance scale level, and quality of health care that are associated with adherence to clinic appointments in HIV positive patients Also from the information obtained, simple, efficient and replicable ways of assessing and maintaining good adherence to clinic appointments may be designed.
Determination of Knowledge, Attitude and Perception of Employers and Employees Towards the Proposed National Health Insurance Scheme in the Central Region - Kampala District.
(International Health Sciences University, 2011-09) Mugisha, William
Introduction. The purpose of this research was to determine the employers and employee’s Knowledge, Attitude and Perception towards the proposed National Health Insurance Scheme in Uganda. The major research objective was to determine the level of knowledge, attitude and perception of employers and employees in the private sector on National Health Insurance Scheme in Uganda. The specific objectives of the research were; to determine the level of employers and employees knowledge on proposed National Health Insurance Scheme, to establish the attitude of employers and employees towards the proposed National Health Insurance Scheme and to establish the employers and employees perception of the proposed National Health Insurance Scheme Methodology A cross section survey research design was used with both quantitative and qualitative data collected using a sample size of 384 respondents. Research findings Findings indicate that there is lack of adequate information to employers and employees and those with a clue about NHIS had inadequate information and with total lack of what the Scheme is to offer. Further, majority responded that whereas the idea is good, the poor services in government hospitals and the existing corruption in the country may not allow delivery of quality health care.That there is need to first eliminate all the corrupt officials, put in place all the required equipments, motivate health workers and then implement the new scheme- NHIS. Recommendations Basing on the findings the study recommends that the government carries out an aggressively tailored sensitization/ promotional program that is geared towards enhancing employee and employers’ knowledge, attitude and perceptions towards NHIS. Further studies should be done to establish facility level of readiness to provide the service for NHIS.
Assessment of Knowledge, Attitudes and Practices of Care Takers of Epilepsy Patients in Burera District, Rwanda.
(International Health Sciences University, 2011-09) Leonce, Byimana
Objective: Burera district has suffered from a high prevalence of epilepsy and the people with epilepsy experience inadequate social and medical treatment. The objective in this study was to assessment of knowledge, attitudes and practices of care takers of epilepsy patients in Burera district, Rwanda. Methods: Care takers in rural district of Rwanda (Burera) completed a self- administered, 35-item questionnaire containing items addressing personal experience with epilepsy, social tolerance, and willingness to provide care, epilepsy care knowledge, and estimates of others’ attitudes. Analyses were conducted to assess characteristics associated with epilepsy management in the community. Results: With respect to how others view people with epilepsy, care takers indicated that among their family members, people with epilepsy are usually feared (48.1%) or rejected (26.9%), with only 20% of care takers reporting that people with epilepsy are accepted. Care takers viewed the community as even less supportive of people with epilepsy, reporting that the community rejects or fears people with epilepsy 49.8 and 39.0%, respectively. Only 7% of care takers feel that people with epilepsy are accepted by their community. Then, the management of epilepsy in the community is negative, as many children with epilepsy cannot be taken to school and adult people cannot find a job, what increase their bad leaving conditions. Conclusions—Knowledge gaps exist in the community on the causes of mismanagement of epilepsy. Care takers expressed both personal and professional reservations about people with epilepsy marrying, studying, and working. This reflects the conditions in which people with epilepsy are put in and more information about epilepsy should be provided to all categories of people.
The Effect of Stigma on Health Seeking Behavior, Adherence to ART and Disclosure of HIV Sero-Status :
(International Health Sciences University, 2011-09) Githongo, Fredrick
Stigma and discrimination is a major obstacle and significant challenge to the success of achieving universal access to HIV prevention, treatment, care and support. The study examined how perceived HIV-related stigma tends to create a “hidden epidemic” of the disease based on socially-shared ignorance, fear, misinformation, and denial. The purpose of this research was to establish the effect of stigma on health seeking behaviour, adherence to ART and disclosure of HIV serostatus. The objectives of the study were 1) to understand the types of stigma that people living with HIV face in Kaloleni district at the Coast Province of Kenya, 2) to determine the effects of stigma on health-seeking behaviour, 3) to establish the effects of stigma on adherence to ART and 4) to identify the effects of stigma on disclosure of HIV serostatus. The null hypotheses’ were: H01: HIV positive-related stigma has no significant effect on adherence to ART and H02: HIV positive-related stigma has no significant effect on disclosure of HIV among PLWHIV. Study design & Methodology: A combination of a cross-sectional study design and a prospective case-series design was used. In this study, 40% of participants were randomly selected from clients accessing some intervention. The research introduced scales that quantify individuals’ reasons for HIV disclosure and adherence. The instruments used were questionnaires and an observation checklist. Quantitative data collected was cleaned coded and entered into an SPSS programme for analysis. Qualitative data was put under themes consistent with the research objectives. The statistical analysis (chi-square) was used to compare socio-demographic characteristics and selected variables between the groups, and to test the hypotheses of the study. Results/Findings: The study established the existence of AIDS-related stigma. In this study majority of respondents had high levels of internal stigma as compared to external stigma. The study established that the People Living with HIV who had high internal and external levels of stigma did not adhere to ARTs. The chi-square test revealed that stigma had an effect on ART adherence and disclosure of serostatus and p-value was =0.05 which was statistically significant. Therefore, the null hypothesis was rejected and the alternate hypothesis accepted. Conclusion: The study findings revealed that stigma negatively affects PLWHIV health-seeking behaviour where the majority did not adhere to ARTs. The findings explored types of stigma and endorsement of various reasons against disclosing. It can be concluded that people living with HIV/AIDS suffer internal and external discrimination. As a result, they do not seek proper medical attention in time despite free drugs availability. Recommendations: Although stigma is considered a major barrier to effective responses to the HIV/AIDS epidemic the complexity of HIV/AIDS related stigma is often cited as a primary reason for the limited response to this pervasive phenomenon. Relevant recommendations have been given to policy makers and health facilities administrators. This study therefore recommends. The media and medics should strive to educate the public on how to treat people with HIV/AIDS and to stop discrimination and stigmatization of such people. PLWHIVs should be counseled sufficiently after knowing their status and should also be followed up on to see how they are progressing with their condition.
The Factors Influencing the Health Promotional Role of Nurses Against Cervical Cancer in Jinja Regional Referral Hospital.
(International Health Sciences University, 2011-09) Nabbowa, Juliet Businge
Introduction: Cervical Cancer is one of the preventable cancers in Uganda with a crude incidence rate of 22.6 per 100,000 population, and 2,464 deaths per year. Eighty percent of the clients report late a situation which can be averted by the nurses if they played their health promotional role against cervical cancer. General Objectives: The main objective of the study was to investigate the factors that influence the nurses’ health promotional role against cancer of the cervix in Jinja Regional Referral Hospital. Methodology: The study was carried among 154 nurses in Jinja Regional Referral Hospital using a cross sectional design. Participants for quantitative and qualitative study were selected using the consecutive and purposive sampling methods respectively. Data was collected on nurses' socio-demographic factors, health system factors, and nurses’ attitudes towards health promotional roles against cancer of cervix using a pre-tested questionnaires and interview guides. Quantitative data was entered in the Epidata and analysed by SPSS software package version 10.0. Qualitative data was analysed by thematic analysis of the response to identify the emerging themes for presentation of results. Results: Nurses with less than nine years of work experience (OR = 2.32, P = 0.011), nurses with salary scale U3-U4 (OR = 10.51, P = 0.027), nurses without a job description (OR = 5.56, P = <0.001) and nurses who follow-up of cancer patient (OR = 7.2, P = 0.001) were more likely to be involved in health promotional activities against cancer of cervix. Overall nurses were less involved in health promotional activities against cancer of cervix. Nurses with negative attitudes towards their health promotional role against cervical cancer (OR = 0.52, P = 0.048), clients involvement (OR = 0.45, P = 0.016) and health promotion as a concept (OR = 0.38, P = 0.004) were less likely to get involved in health promotion against cancer of the cervix. Conclusion: Overall nurses were less involved in health promotional activities against cancer of cervix. Generally nurses in Jinja Regional Referral Hospital had a positive attitude towards health promotion against cancer of cervix. Nurses with less than nine years of work experience, salary scale U3-U4, without a job description and nurses who followed-up cancer patients were more likely to be involved in health promotional activities against cancer of cervix than those who were not. Recommendation: It is recommended that the Ministry of Health strengthens the cervical cancer prevention programs while providing logistic and in-service training to the health workers so as to increase accessibility and utilisation of cervical cancer prevention services by the clients. Jinja District uses various approaches and media to disseminate health promotional messages against cervical cancer as the hospital conducts three continuous medical sessions on cervical cancer per quarter and gives support for follow up visits. The Ministry of Health and nursing council needs to strengthen its supervisory role to change the nurses’ attitudes towards preventive services.
A Cross Sectional Study of the Knowledge, Attitudes and Practices Regarding Utilization of Modern Contraception Among Women and Men of Namuwongo.
(International Health Sciences University, 2011-09) Nakaggwa, Florence
The United Nations Population Fund (UNFPA) estimates that the world´s population will be 8 billion in 2050. This increase is attributed to the high population growth rate which is influenced by the world´s total fertility rate and contraceptive prevalence rate (CPR). UNFPA has embarked on a drive to increase CPR particularly in developing nations with a focus on modern contraceptive methods, with the hope that this will contribute to a reduction in the overall world population. Uganda´s theme for this year was ¨Uganda at 33 million; Time to Act¨. With an annual population growth rate of 3.3% and a total fertility rate of 6.1, the country needs to increase efforts towards use of modern contraception. This is because there is a high population of unproductive youth in the reproductive age group who are migrating into urban slums where health services and living conditions are inadequate. The purpose of this study was to identify the knowledge, attitude and practices regarding the use of modern contraception among the men and women of Namuwongo slum. Methodology: A cross-sectional study of 282 respondents between the age 15-49 (for the women) participated in the study. Residents who were mentally challenged, and female residents who did not lie in the age range were excluded. Standardized pre-coded and structured questionnaires were used to obtain information from the respondents. The independent variable was use of modern contraception while the dependent variables were knowledge, attitude and practices regarding modern contraceptive use. Results: 193 were females, while 89 were male. 51.1% were youth in the age range 15-24 years. 40.8% of the respondents were unemployed and 63.8% were married. 39.7% of respondents admitted to using contraception. 11.9% of those who said that they were not using contraception, however, they admitted to using condoms which implied that they did not recognize condom use as a method of contraception. This raises the CPR to 46.8%. Nonetheless, 13.5% were contemplating discontinuing use of modern FP because of side effects. The commonest methods were condoms and injections. Knowledge of methods was 78.7%. At p<0.05, knowledge, spousal communication, and final decision making was statistically significant. 60.3% of respondents were not using a modern method of contraception. Side effects constituted 52.1% of perceived obstacles to use of modern contraception. Conclusion: Knowledge of contraception was relatively high, however, CPR is low for a community that has such a high population of youth that are unemployed. The major hindrance which is side effects needs to be addressed to dispel myths surrounding modern FP use. The role of men in influencing modern FP use is important because they are the ones with limited knowledge on FP yet they take part in decision making about the matter.
Determinants of Place of Delivery Among Mothers in Kigungu, Entebbe Health Sub District Wakiso District
(International Health Sciences University, 2011-09) Wavamunno, Priscilla
The study was carried out in order to identify determinants of place of delivery among mothers in Kigungub Entebbe health sub district in Wakiso district. The general objective of the study was the place of delivery of rural mothers. The specific objectives were to determine social demographic factors, maternal factors, cultural factors and health related factors that influence place of delivery among rural mothers in Wakiso district. The study was carried out in Kigungu community, Entebbe health sub district Wakiso district. This is mainly a rural area and it was assumed that mothers here do not deliver in health units for unknown reasons. The district has 7 health sub districts of which only one health sub district was chosen using the simple random method (fish bowl method) as the study area. It was a cross sectional study involving 374 mothers who had delivered a baby in the last 2 years preceding the study and were found living in Kigungu regardless of their duration of stay in the area. The mothers were identified using the snowball method of sampling. Data was collected using an interviewer administered questionnaire to the mothers by the researcher together with the help of research assistants. Data was then coded, cleaned and entered into the computer using EPI-DATA version 3.1 and analysis done using EXCEL 2003/7 and SPSS version 18. Data was presented using frequency distribution, and cross tabulations and statistical tests such as chi square run. The study revealed that the mothers in Wakiso district, the majority of them were 30 years and below (75.4%), married 69.3%, Catholics 35.3%, 42.8% had primary as their highest level of education and 46.8% had either 1 or 2 children. Eighty nine percent of the mothers reported to have delivered in health units while 84% of them went for ante natal care services. Among the determinants of place of delivery in Kigungu village were social demographic factors like parity and religion with p value of 0.001 < the level of sighficance 0.05. Mother’s culture and health workers’ competence were signficant in determing place of delivery with p value of 0.001 < the level of signficance 0.05. Age did not have any significant influence on the place of delivery.
Factors Influencing Performance of Nurses and Midwives in Mbale Regional Referral Hospital - Mbale Uganda
(International Health Sciences University, 2011-09) Odella, Monica
A study on factors influencing the performance of nurses and midwives in Mbale Regional Referral Hospital was carried out in Mbale District. The objective of the study was to establish the factors influencing the performance of nurses and midwives of Mbale Regional Referral Hospital. The study employed a descriptive cross sectional study design and the study population was the nurses and midwives in Mbale Regional Referral Hospital. The study results established majority of workers as nurses and midwives and are not accommodated. Results also revealed that lack of protective gear, inadequate communication system, overwhelming number of patients, led to inadequate performance of nurses and midwives that was made worse by inadequate supervision. These were negative factors however nurses and midwives are encouraged to perform as they had available post exposure prophylaxis, guidance forms for duty and leave roster and the welfare especially when they lose relatives. The working environment coupled with short supply of equipment, sundries, medicine and space compromise performance of the nurses and midwives. Irregular supervision and motivation, appraisal feedback and timing of activities had negative influence on the nurses and midwives performance .Working relationship and lack of appropriate job description were found to have negative influence on performance. Improve on nurses conditions of service that affect their attitude to perform adequately like their confirmation and promotion which administration can influence The research recommends that there is need to motivation of nurses and midwives, by providing enough resources to let them perform the duties. Internal support supervision is very crucial to monitor performance of nurses and midwives There is need to provide protective gear to ensure that nurses and midwives are not at risk of being infections. There is also need to do ward rounds appropriately and on time to give the nurses and midwives ample time to do the rest of the nursing care. The study limitations were time not being enough to cover a larger population and funding was inadequate for the study
Comparing Sexual Reproductive Health Needs and Practices in Relation to their HIV Sero-Status :
(International Health Sciences University, 2011-09) Patta, Emmanuel
Introduction: This study compared the sexual reproductive health needs and practices of HIV positive and HIV negative adolescents in Tororo district. The independent variable being HIV sero-status of the adolescents and sexual reproductive health needs and practices of these adolescents the dependent variable with the following specific objectives; 1. To compare the prevalence of condom use among HIV positive and HIV negative adolescents in Tororo district. 2. To compare the prevalence of pregnancy/impregnation among HIV positive and HIV negative adolescents in Tororo district. 3. To comparatively identify possible HIV risky behavior and practices among HIV positive and HIV negative adolescents. 4. To comparatively assess attitudes of HIV positive and HIV negative adolescents towards HIV prevention. Methodology: Causal comparative study design using a combination of quantitative and qualitative methods. Random samples of 99 HIV positive adolescents drawn from TASO Tororo and 99 HIV negative adolescents from Reproductive Health Uganda’s VCT and Youth center Tororo; aged 10-19, aware of their HIV sero-status. Data entered in SPSS and analyzed using Pearson Chi-square test. Findings: No significant difference in the prevalence of condom use, no significant difference in the prevalence of pregnancy/impregnation and no significant difference in HIV risky behavior and practices among HIV positive and HIV negative adolescents. However, there was significant difference in their attitude towards HIV prevention. Recommendations Both HIV positive and negative adolescents need heightened prevention interventions as many data continue to engage in risky behaviors like multiple partnering, having sexual partners of unknown HIV sero status and non-disclosure of HIV sero status to sexual partners. Teachers, parents and other care providers to adolescents and especially to the HIV positive adolescents need to be empowered with knowledge and skills on the sexual reproductive health needs of these adolescents. The HIV prevention message appropriate for adolescents in the age group 10-14 is abstinence as the majority here is not sexually active. Abstinence as HIV prevention measure is not adopted by many adolescents in the age group 15-19 and therefore service providers to adolescents should rather along with abstinence emphasize safer sex practices. Strategies to prevent adolescent pregnancy including community programs to improve social development, responsible sexual behavior education and improved contraceptive counseling should be implemented at the family and community level. Further research needs to be replicated in other geographical areas with adolescent samples not in care and employ a study design which could probably control factors like window period for the HIV negative adolescent group.
Occupational Safety and Health Hazards in the Tea Plantation Industry :
(International Health Sciences University, 2011-09) Babirye, Eva Christine
Introduction: Workers in the tea plantation industry in Uganda are exposed to several occupational health hazards yet there is an acute shortage of information relating to safety and health in the tea plantation industry because these have not been adequately studied. The main risks posed arise from the negligent use of fertilizers, chemicals and unguarded machinery by unskilled casual labourers leading to numerous mechanical and chemical hazards that result in many accidents. This study focused on investigating the occupational safety and health (OSH) hazards in tea plantation estates. It also assessed workers knowledge and attitudes on occupational safety and health hazards. The research was expected to create awareness and deepen the understanding on the problem of OSH hazards in the tea plantation industry to help in planning steps and interventions to prevent common occupational injuries and accidents in tea estates. Research Question: What are the occupational safety and health hazards in Mityana tea Plantation?\ How is the reporting, documentation, and management of occupational injuries and diseases done in Mityana tea plantation Estate? Objectives: 1.To identify the occupational safety and health hazards at Mityana tea plantation Estate. 2. To assess workers knowledge and attitude on prevention of occupational hazards at Mityana tea plantation Estate. 3. To describe the reporting, documentation and management of occupational injuries, accidents and diseases experienced by tea workers at Mityana Tea Plantation Estate.. Methodology: Descriptive study using cross-sectional and retrospective design was used. Respondents were selected from both the field and factory based on stratified random sampling method, where the population was divided into strata basing on gender alone in order to ensure adequate representation of male and female from each division with shared occupational health and risk attributes. Then a random sample from each stratum was taken in a number proportional to the stratum's size compared to the population size (200). Finally these subsets of the strata were then pooled together forming a random sample. The study was carried out from September to October 2011 at Mityana tea plantation estate located in Mityana District. Findings: 66.5% of the workers work in the field compared to 32.5% in the factory, with most injuries being experienced in the factory (67.9%) compared to the field (32.1%) implying that risk of injury was greater in the factory than in the field. Injuries resulting from physiological strain and physical factors like harsh climate, vagaries of terrain, chemical hazards, and snake bites were the most prevalent amongst plantation workers in the field while injuries of a minor nature resulting from mechanical risk factors that mainly affected the upper and lower limbs were the most prevalent in the factory. Most workers (65.2%) reported their injury and documentation was maintained, 34.8% did not report, while many (69%) frequently reported their injury after several days despite the presence of an established reporting protocol. Recommendations: 1. Need to promote the knowledge and labor rights of the tea plantation estate workers regarding safety and health. Employers too need to be informed about health and safety risks in the workplace because they have the moral and often legal responsibility to protect workers.2. Sensitization meetings on OSH hazard prevention and periodic training on safe work procedures to prevent accidents and injuries with special emphasis on training on PPE usage and First aid respectively.3.Continuous and consistent maintenance of records on work place injuries, to enable monitor the progress on occupational safety and health in the tea estates.
Factors Influencing Performance of Nurses and Midwives in Mbale Regional Referral Hospital - Mbale Uganda.
(Internationl Health Sciences University, 2011-09) Odella, Filder Monica
A study on factors influencing the performance of nurses and midwives in Mbale Regional Referral Hospital was carried out in Mbale District. The objective of the study was to establish the factors influencing the performance of nurses and midwives of Mbale Regional Referral Hospital. The study employed a descriptive cross sectional study design and the study population was the nurses and midwives in Mbale Regional Referral Hospital. The study results established majority of workers as nurses and midwives and are not accommodated. Results also revealed that lack of protective gear, inadequate communication system, overwhelming number of patients, led to inadequate performance of nurses and midwives that was made worse by inadequate supervision. These were negative factors however nurses and midwives are encouraged to perform as they had available post exposure prophylaxis, guidance forms for duty and leave roster and the welfare especially when they lose relatives. The working environment coupled with short supply of equipment, sundries, medicine and space compromise performance of the nurses and midwives. Irregular supervision and motivation, appraisal feedback and timing of activities had negative influence on the nurses and midwives performance .Working relationship and lack of appropriate job description were found to have negative influence on performance. Improve on nurses conditions of service that affect their attitude to perform adequately like their confirmation and promotion which administration can influence The research recommends that there is need to motivation of nurses and midwives, by providing enough resources to let them perform the duties. Internal support supervision is very crucial to monitor performance of nurses and midwives There is need to provide protective gear to ensure that nurses and midwives are not at risk of being infections. There is also need to do ward rounds appropriately and on time to give the nurses and midwives ample time to do the rest of the nursing care. The study limitations were time not being enough to cover a larger population and funding was inadequate for the study.
The Role of Media on Sexual Attitudes and Behaviour Among the Secondary School Adolescents of Kawempe Division, Kampala.
(International Health Sciences University, 2011-09) Pardon, Akugizibwe
The rate of exposure to media of all forms by adolescents all over the world is on the increase (Rich, 2005). Media often carry information on adolescent sexuality which can influence both the sexual attitudes and behaviours of secondary school students to which they are exposed. This study was carried out to assess the role of four forms of media (the radio, television, newspapers and the internet) on the sexual attitudes and behaviour of secondary school adolescents in Kawempe Division. The study had four specific objectives that is, to determine the type of sexual information in media secondary school adolescents of Kawempe Division are exposed to; to identify the most preferred form of media for sexual information by secondary school adolescents of Kawempe Division; to establish the influence of media on sexual attitudes of secondary school adolescents of Kawempe division; and lastly to assess the influence of media on sexual behaviours of secondary school adolescents of Kawempe Division. The study adopted a cross sectional survey type of design, it was both descriptive and analytical. Both qualitative and quantitative data was collected using a self administered questionnaire, key informant interviews and an observation checklist. Data collected using self-administered questionnaires from three hundred and ninety (n=390) students (respondents), was analysed using SPSS and findings presented according to the study objectives. It was found that the media has both positive and negative sexual information although the former was generally more predominant in most forms of media. Such information included abstinence messages, contraceptive use, family planning and pregnancy care. The study also found that adolescents in secondary schools of Kawempe Division prefer the radio (33.8%) to any other form of media for providing educative sexual information. Data analysis also indicated that of all forms of media, newspapers and TV influenced adolescents’ sexual attitudes the most; reading newspapers with sexual information was found to be significantly associated to the sexual attitudes of the students (X2= 5.86, P= 0.016). Further, those who read newspapers with educative/ positive sexual information were three times more likely to abstain from sex (OR= 2.75, C I [1.46–5.15], P=0.002), while those who watch televisions with educative sexual information were two times more likely to abstain from sex (OR=2.44, CI [1.33 – 4.50], P=0.004). This study concluded that the media generally contains more positive sexual information for school adolescents; the radio is by far the most preferred form of media for sexual information by adolescents in secondary schools; sexual information in media positively influences the sexual attitudes of secondary school adolescents in which students tend to engage in sexual activity due to such exposure while exposure to educative sexual information in media (especially TV and newspapers) is likely to influence the sexual behaviours of secondary school adolescents by causing them to abstain from sex. The study recommends that communication to adolescents in secondary schools about their sexuality be done through the radio since they (adolescents) prefer the radio to other forms of media for such information. Since adolescents tend to have a positive attitude towards sexual intercourse due to exposure to media with sexual information, media houses need to communicate information such as consequences of students’ involvement in sexual activity (like contracting HIV/STDs, unwanted pregnancies, school dropout among others). Further, it is hereby recommended that articles/ information on abstinence be included in newspapers and aired on television as these forms of media are more likely to influence adolescents’ sexual behaviours and encourage abstinence from sex by the students.
Assessment of the Appropriateness of the Cessation of Breast Feeding Before Two Years by HIV-Positive Mothers.
(International Health Sciences University, 2011-09) Babughirana, Geoffrey
This study was to establish whether HIV positive mothers with weaned children below 2 years meet the AFASS criteria at the PMTCT clinic. The Main Objective of the study was to assess the AFASS criteria for HIV positive mothers with children below 2 years who stopped breastfeeding. And the specific objectives were to assess the acceptability and Feasibility of the feeding practice for the mother, to assess the affordability and sustainability of the feeding practices by the mother and lastly to assess the safety of the feeding practice and the Nutrition status of the child in relation to the feeding practices. Methodology: The research was a cross sectional survey on 378 PMTCT mothers and their infants aged 6-24 months receiving care from Kirudu, Kiswa, Komamboga, Kitebe, and Kisugu health centres of Kampala City. The sample size was determined using Kish’s formula. Data collection techniques and Instruments used were the observation checklist. Questionnaire guide with open ended questions and a MUACtape, data was then entered in the computer using Epi Info, analysis done using the SPSS and Excel. Each of the Criterions was given scores to come up with the desired results Results from the study showed that of the 378 clients 67.9% opted for animal milk, 15.6% complementary feeds, 9.8% for infant formula and 6.6% a non-milk diet. From these respondents 53.9% were found to have made an acceptable choice, 49.8% have practiced a feasible option and 12.9% could actually afford the choice they made, 28.8% were practicing a safe option and 56.1% could sustain their choice. With such results the study therefore led to a conclusion that counselling mothers on infant feeding options basing on the AFASS criteria is not realistic and the health system should consider other practical interventions such as exploring practices like heat treatment of expressed breastmilk, investing in community based monitoring of these clients and localized recommendation for AFASS
Assessment of the Road Safeness and Prevalence of Road Traffic Accidents in Uganda:
(International Health Sciences University, 2011-09) Nankya, Prossy Lwanga
The study was carried out to assess road safeness and prevalence of road traffic accidents in Uganda; it was a cross-sectional survey with both qualitative and quantitative data collected. Findings indicated that road traffic accidents affect pedestrians more than any other road user, the major human cause of accidents was careless driving and most accidents occurred in the evening between 4pm and 8pm, morning between 7am and 8am and lunch time between 12 noon and 2pm. All roads were congested with many pot holes, had no pedestrian walkways and few safety features. Most vehicles lacked certain parts critical for safety. Corruption was the major factor affecting implementation of road policies. The study recommends educational campaigns through schools, review of vehicle inspection system and safety controls, adequate traffic signage, safety features including pedestrian walkways, adequate training to traffic police officers and provision of adequate resources. Background: Everyday approximately 3,000 people die and 30,000 people are seriously injured on the world’s roads (WHO 2004). Globally, trauma resulting from road traffic crashes is a major cause of death and disability with the majority occurring in developing countries (Nantulya et al 2002). According to Injury Control Centre Uganda Executive Director (2009) 44% of all injuries presented in hospitals are due to road traffic crashes. In Uganda, road traffic crashes have increased by 90% since 2000 and in 2007 almost 10,000 people were injured and over 2,000 died from road traffic accidents; this puts a significant strain on the already stretched health facilities and poor families who may experience the loss of income from a bread winner in addition to the burden of caring for those injured. Objectives: Major objective; To assess the road safeness and accident prevalence in central region. Specific objectives: To establish the prevalence of road traffic accidents in Kampala area. To determine the human factors influencing road safety in Kampala area. To determine the condition and terrain of the roads in Kampala area. To determine the vehicle conditions affecting road safety in Kampala area. To determine the factors influencing implementation of road policies Kampala area. Methodology: the study was a cross-sectional survey with both qualitative and quantitative data collected. 192 respondents were interviewed, of which 48 were drivers, 48 were passengers, 48 were riders and 48 were pedestrians. Observation was done on all the 20 roads in the study for a period of one hour. 40 vehicles were examined, every fifth vehicle parked on the different roads was chosen. Results Source: Primary data. The figure shows that 36.4% of drivers wore seat-belts while 63.6% did not wear seat-belts. 25% of riders wore helmets while 75% did not wear helmets. 70% of drivers and riders were distracted with 65% talking to passenger, 31.6% talking on phone, 25% reading newspapers and 5% were texting on phone. Figure 2 shows that pedestrians are affected most in road traffic accidents with 49.47% killed, 41.57% seriously injured and 36.82% slightly injured. The figure shows that most accidents occur in the evening, between 4pm and 8pm; in the morning hours between 7am and 9am; and lunch time between 12 noon and 2pm. Implementation of road policies is mainly influenced by corruption, limited resources, driver ignorance and personnel shortage as shown in the figure below. Discussion Findings indicated that pedestrians were more affected in road traffic accident which is in contrast to the results from analysis of factors affecting road safety: the Greek experience (Golias. J. C.et al, 1997) where more drivers were affected followed by passengers and pedestrians. Human factors accounted for 95.26% of road traffic accidents which is consistent with results of the comprehensive study of road safety (Treat et al, 1977) where human factors accounted for 57%. The hourly variation of 4pm to 8pm is consistent with the Greek experience (Golias, J. C.et al, 1997) where a significant number of fatal accidents occurred during evening hours (6pm to midnight). This can be attributed to rush hour movement as people travel back home with most of them tired from the day’s work. The roads had no pedestrian walkways, with many pot holes and poor drainage which leads to wear and tear of roads. The road condition is also affected by overloading which deteriorates the road net work and reduces road life span (Watkins et al, 2009). Conclusion: Pedestrians were the most affected road users in Uganda during 2010. Human factors cause more road traffic accidents than vehicle, road factors. Ugandan roads were in a poor state and yet too congested. Vehicles lacked certain parts critical for safety. Corruption was the major factor influencing implementation of road policies. Recommendations: There should be educational campaigns on traffic safety, review of the vehicle inspection system, improved road condition through adequate traffic signage and safety features including construction of pedestrian walkways and provision of adequate resources for traffic police department.

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