Bachelor of Science Public Health

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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.
Factors Contributing to the Choice of Place of Delivery by Mothers Aged 15 - 49 Years in Bumanya Sub County, Kaliro District.
(International Health Sciences University., 2012-09) Nabirye, Suzan
Background: The choice of place of delivery contributes to maternal mortality as it determines the care the mother receives during childbirth, and 80% of the deaths occur during this period (MDG report, 2010). Objective: To establish the factors that contributed to the choice of place of delivery among mothers aged 15-49 years in Bumanya Sub County, Kaliro district in order to suggest functional interventions that would encourage institutional deliveries. Method: A cross-sectional study design was employed with researcher administered questionnaire technique as method for collection of data from 380 respondents who had given birth within two years prior to the study. Data was collected on the background characteristics, choice of place of delivery, socio-demographic, health facility and individual factors. Descriptive, Bivariate and multivariate analyses were undertaken in SPSS and frequency tables, pie-charts, graphs, odds ratio and pvalue were generated. Results: Health facility births were 74% which was higher than the national (38%), with 27.10% being private births. Yet only one Private health unit is registered that offer delivery services. Similarly, availability of birth attendants (OR=3674.11,95% CI=246.80-548.96, pvalue<0.0001), availability of supplies (OR=15.90, 95% CI=3.28-77.22, pvalue=0.001), health workers’ attitude (OR=0.1, 95% CI=0.00-0.30, pvalue=0.008), accessibility to facilities (OR=0.02, 95% CI=0.00-0.48, pvalue=0.016), occupation (business, OR=0.05, 95% CI=0.00-0.121,pvalue=0.001) and education were revealed by the study as key predictors of choice of place of childbirth. Conclusion: The socio demographic, health facility and individual factors act together to influence mothers’ choice. Therefore, multi-sectoral approach should be adopted to improve maternal health.
Discipline and Academic Performance Among School Going Children :
(International Health Sciences University., 2012-09) Hodan, Said
A 2005 Save the Children study in Uganda showed that school children are routinely beaten and humiliated at school, despite many teachers saying they do not hit children. Therefore, corporal punishment is brought to light only when a child is severely injured, pointing out the absence of a monitoring system to ensure that such abuse of power by teachers does not take place. Additional data on the nature and prevalence of child disciplinary practices worldwide are needed to establish baselines, inform development of strategies to prevent violent disciplinary practices and monitor progress. The objective of this study was to establish a link between discipline and academic performance by doing so my work tried to determine a link between the types and forms of discipline used on school going children in different settings (at home and in school) and the academic performance of those children. The study found that there was a significant association between the types of discipline used at school and at home with the academic performance of those school-going children. However, when the variable ever been punished or the forms of punishment were tested in the different settings (at home and in school) it showed that there was no significant association between ever been punished and the forms of punishment and academic performance. These results correlate with the theory that corporal punishment can be related to characteristics that are related to cognitive ability, but not the theory that corporal punishment interferes with cognitive ability. Further studies can go forth to explore other determinants of punishment at home or a comparative study on discipline in private and public sector in order to provide sound evidence on how violence at home relates to the overall performance of a child and the child's development. This work provides data that could guide the development and improvement of educational efforts to address norms, attitudes and behaviors harmful to children and improve laws, policies, regulation and services that contribute to children’s well being and protection.
Influence of Cultural Practices on Modern Contraceptive Use Among Women of Reproductive Age :
(International Health Sciences University., 2012-09) Nanteza, Shadia Mugizi
Every year, Uganda loses about six thousand women as a result of pregnancy related complications. A significant proportion of these occur because women aren't able to have a health planned pregnancy. In Uganda (UDHS, 2005) ,41% of the married women wish to space their pregnancy or want to stop child bearing but they are not using contraceptives methods because they have unmet needs contraceptive use or because of various reasons including social cultural practices. This study was to determine the influence of cultural practices and other factors on contraceptive use in urban areas specifically lower cell 7 Nyamitwobora village, Mbarara municipality. The main objective was to determine the influence of cultural practices and other factors on contraceptive use among women of reproductive age. A case study in lower cell 7 Nyamitwobora village, Mbarara municipality. A cross sectional study was used. The women recruited in the study were of reproductive age from 18-45 years and were residents in local council 7 Nyamityobora village Mbarara municipality A total sample population of two hundred and eighty respondents was used. Simple random sampling was used for the study was used to select the respondents. The methods used to enrich the study included questionnaire, interviews and observations. The analysis of the study involved tabulation of the frequencies to get the percentages and calculations using SPSS and excel computer programs. The study revealed that cultural practices and other factors have a great influence on contraceptive use. It was evidenced with early marriage, male child preference, lack of autonomy for women on total number of children, community influence on contraceptive use, need for very many children and religious influence on contraceptive use which have led to decreased contraceptive use among women of reproductive age in lower cell 7. The recommendations for the study involved male involvement in contraceptive use and need to educate the women about their reproductive health rights so that both the husband and wife have equal rights to decide on the total number of children they can afford, as well as education on equality of both the male and female child so as to avoid male child preference.
Factors Influencing Uptake of Vasectomy Among Men in Mbuya II Parish, Nakawa.
(International Health Sciences University., 2012-09) Nakku, Jalia
Introduction: Over the past few years in Uganda, Vasectomy among other modern family planning methods has attracted huge publicity in an effort to draw men’s participation in contraception. Despite the continued efforts, there is a lag evident by a low uptake of vasectomy, consequently the research. Objective: The main aim of the study was to determine factors influencing uptake of vasectomy among men in Mbuya II parish, Nakawa division. Methodology: Questionnaires and focus group discussions were the primary data collection tools. A pretested questionnaire was used for a sample size of 384 men aged 15-64 years randomly selected and 12 focus group discussions were carried out. Results: Men who had attained at least secondary education would opt for vasectomy but not the case among the elderly. Furthermore, majority of the respondents had knowledge on vasectomy; 80% of the men knew that vasectomy is permanent, 70% knew that it is irreversible and 53% knew it does not prevent against STIs and HIV/AIDS. Men had negative attitudes towards vasectomy that is regarded as castration, leads to impotence and a risk factor of cancer. Conclusion: According to the results, most men had good knowledge about vasectomy despite their poor attitudes. Therefore, sensitization needs to be done so that the elderly could uptake vasectomy. Additionally, there is a need for more information, communication and education for men about vasectomy to change their attitudes about it.
Factors Influencing Self-medication Practices Among Adults in Urban Slum Households:
(International Health Sciences University., 2012-09) Oniba, Opio Rufino
Background- Medicines when used properly are the most effective substances for alleviating symptoms and curing ailments. However, it becomes disastrous when irrationally used as most of the symptoms and microbial that they are meant to alleviate and kill will develop resistance to the substances. Self-medication has been identified as the main form of irrational drug use in urban slums that is perpetuated by health care system factors and socioeconomic factors. The Main Objective- This study was carried out to investigate the factors associated with self-medication practices among adults in households of Namuwongo Slum and suggests relevant recommendations for mitigation Methods- This descriptive cross-sectional study was structured to investigate health care system factors, drug regulatory policies and the availability of some of these medicines in the market for individual’s disposal. The investigation was done among the households residing in one of the prominent slums of Kampala known as Namuwongo in Bukasa Parish in Makindye Division using interview guide/questionnaires and Focus Group Discussion. In the study 329 households were sampled from the two zones, A and B of Namuwongo Slum. The result- This revealed prevalence of Self-medication at 72% of which the most common type of illnesses treated include; Respiratory tract infection (38.7%) Headache and Fever (24.8%), Gastro-intestinal disease (20.4%) and others (16.1%) with Antibiotics (49.2%) and painkillers (30.2%) being the most used Specific western medicines in self-medication in the urban slum. Conclusions- Poor national regulatory policies and networks on pharmaceuticals dealings that avails the public with varieties of choices of drugs, Socioeconomic factors such as Income, Gender and Education level play great role in promoting extensive self-medication practices in the urban slums. So this investigation was timely enough to respond to the world-over medical experts’ concern, to imagine a new world without anti-microbial in the nearest future that will be worse than the pre-allopathic medicine period by suggesting life saving recommendations. Recommendations- It is worthy recommending the Government at this point to regulate the operation of the private health facilities such as drug shops and Clinics, streets Drug vendors in order to protect the poor people from being conned to consume medicine indiscriminately.
The Role of Living Conditions in Informal Settlements on Perceived Risk of HIV Infection Among Fishing Communities:
(International Health Sciences University., 2012-09) Omia, Geoffrey
The study examined the role of living conditions on perceived risks of HIV infections among the fishing communities at Namasale landing site, Amolatar District. A descriptive Cross-Sectional survey was used by a systematic sampling to collect samples of 99 respondents aged 18 years and above. Of these, 86 (86.9 %) respondents fully completed the study questionnaires. Data was collected using an interview structured questionnaire after seeking their consent and was entered using an EPI – Info for window version three, cleaned and exported to SPSS version 10 analyses. Statistically significant variables were ranked using Pearson’s Correlation of (P=0.05). Study findings indicated that the majority of fishing communities earns less than 2000 UGX a day with 53.5% of them living in semi permanent households. Although 68.6% of the respondents have knowledge about HIV/AIDS, their causes and mode of preventions but still the study revealed that the number of sexual partners in this community has greatly influenced the perceived risk of HIV infections among the fishing communities, with 62.8% of other factors contributing to HIV infection were reported among the married population within the fishing communities. Recommendations are made on broader directions such as specific policy interventions, interventions in HIV/AIDS preventions and controls, Community policing in crime preventions and sensitizations, needs for better improvements on housing and the living conditions among the fishing communities.
The Influence of Hygiene Practices on Perceived Food Safety at Make-shift Eating Places :
(International Health Sciences University., 2012-09) Monicah, W. Wambugu
This study set out to determine the influence of hygiene practices on perceived food safety at makeshift eating places in Kawempe division-Kampala district. Specifically the study objectives were: to identify hygiene practices of food vendors; establish the perceived level of food safety at makeshift eating places; find out the link between hygiene practices and perceived food safety and document other determinants of food safety at makeshift eating places. In a case study design, 150 food vendors and 30 consumers and 30 makeshift eating places were sampled, interviewed and observed in Kawempe division Kampala district. Primary data was collected using questionnaires, observation check lists and Focus Group Discussions. The study was a success. The findings showed that the hygiene practices had opportunities for improvement in food preparation, handling, storage, and personal hygiene. Majority of the food vendors put their economic interests first other than food safety. Safety did not come first among the consumers who perceived food to be safe because it was freshly prepared. It was safe to conclude that hygiene practices of food vendors at make shift eating places may not necessarily influence perceived food safety of the consumers evidenced by the fact that the hygiene practiced were generally below standards of good practice observable in an ideal condition, and that the consumers had other consideration in mind to look for other than safety issues when choosing an eating place. This study recommended the training of street food vendors on hygiene practices so as to improve the knowledge, attitude and practices that surround the low occurrence of hygiene practices among food vendors of makeshift eating places, and that Kampala City Council Authority should intensify health education regarding food hygiene and safety to both food handlers and consumers with view to mitigate public health problems linked to hygiene practices and perceived food safety; advocate for policies that capture makeshift eating places, provide specific sites for the make shift eating places that have safety measures in consideration and finally teach alternative cooking methods to the vendors that would lessen the use of reused oil. The following areas of further research emerged from the study; Link between hand washing and rate of bacterial infection; determinants of perceived food safety and link between makeshift eating places and customer income.
A Study of the Knowledge and Attitude of Women of Childbearing Age (15-49 Years) Regarding Utilization of Cervical Cancer Screening Services :
(International Health Sciences University., 2012-09) Ssenkumba, Joseph
Background: Cervical cancer is a public health issue that kills at least 250 000 women every year: 80% of women who die come from low and middle-income countries like Uganda. (WHO Report of the GAVI–UNFPA 2009). Broad objective: To identify the factors which influence the utilization of cancer screening services among women of child bearing age Methods: This was a cross sectional descriptive study design which was conducted in kisugu parish found in Makindye Division Kampala district. It included women of childbearing age from the ages of 15 - 49 years in the community of Kisugu parish who were purposively selected from households. The researcher developed a structured, precoded and pretested questionnaire and interviewed 369 WCBA to collect quantitative data from WCBA of age 15-49 years. SPSS statistical package was used in the data analysis. Results: The majority of the 369 included participants were with an education mostly up to primary level. Knowledge about the importance of the Pap smear, presence of cancer screening services, was adequate (64.7% and 53.3%, respectively) but awareness of cervical cancer risk factors, causes, signs and symptoms was quite low. The most frequent reasons for avoiding Pap smear screening were fear of pain associated with vaginal examination (7%), embarrassment (53.3%), and cost of the procedure (22%). Knowledge factors associated with cervical cancer, barrier to utilizing screening services were the most significant followed by health system factors which did not greatly influence utilization of screening services except attitude of health workers and presence of screening services at the health facility. Conclusion: If we can improve the knowledge and attitudes about Pap smear cervical cancer screening in both the subjects and the health care providers, the health workers should be able to readily provide appropriate and accurate information to the population to motivate the general population to join screening programs.
Investigate Factors Affecting Adherence to Iron/Folate Supplementation Among Pregnant Women Aged 20 - 40 Years in Kapchorwa Hospital, 2012.
(International Health Sciences University., 2012-09) Achebet, Sylvia
Introduction: The study sought to investigate the factors affecting adherence to IFA among pregnant women aged between 20 and 40 attending ANC at Kapchorwa Hospital. Main objective: To investigate the factors affecting adherence to IFA supplements among pregnant women attending ANC at Kapchorwa Hospital. Methodology: A descriptive cross sectional study using convenient sampling method was used to collect data from 384 pregnant mothers. Qualitative and quantitative data was collected using a questionnaire that had questions on socio-demographic characteristics, predisposing, reinforcing and enabling factors was administered to the eligible mothers. The raw data was entered into epidata and exported into SPSS for analysis. Descriptive, bivariate and multivariate logistic regression statistical analyses were used. Results: Of the 326 pregnant women interviewed, 195/326 (60%) were adherent to IFA supplements. Parity of 4 or less (OR=2.1, CI=1.06-3.70, p=0.02), four or less previous ANC visits (OR=0.31, CI=0.13-0.73, P=0.004) and mothers who had social support (OR=3, CI=1.7-4.78, P<0.001) were significantly associated with adherence to IFA supplements. Conclusion: The overall level of adherence was higher than the national estimates although lower than recommended level. Mothers with low parity of less or equal to 4, four or more previous ANC visits and social support from family members were likely to adhere to IFA supplements among women attending ANC in Kapchorwa Hospital. Recommendations: Continuous sensitization of the mothers on the importance of adherence to IFA coupled with improved nutrition; need for early ANC attendance and at least 4 ANC visits during every pregnancy for continuous monitoring on adherence and follow up; ANC cards should be modified by MOH to enable monitoring of adherence to IFA so that defaulting mothers can be identified and supported accordingly; and health workers should provide the appropriate support to mothers of high parity (more than 4 children) to avoid complacency and improve adherence to IFA.
Health Care Waste Management and Occurrence of Occupational Hazards :
(International Health Sciences University., 2012-09) Mujjabi, Martin Mukasa
Occurrence of occupational hazards has raised issues of Health care waste management amongst health workers. Reports of 39 health workers claiming for compensation after the Uganda Ebola outbreak in 2000 resonated the issue of occupational safety in health care settings yet these do not only affect the employees but also the clients and the community neighboring the health center. The aim of the study was to assess the HCWM and occurrence of occupational hazards in the health sector of Pabbo Sub County. The specific objectives were to: (i) document the HCWM practices, (ii) assess the knowledge of health workers on HCWM, (iii) document occupational hazards occurring, and (iv) to describe the management of occupational hazards in Pabbo Sub County, Amuru district. The study was a descriptive cross sectional study that used a census among health workers of Pabbo Sub County in all the eight operational health facilities in August- September 2012 irrespective of time they had been working in the area. The study population was 72 of all those who delivered health services as per the definition in Uganda Health services Commission Act and eight (8) HFs. Researcher administered checklists and questionnaire were used to collect information from each health facility and willing respondents in the study. Permission was sought from IHPM of IHSU and an introductory letter issued for the authorities of the district and the health centres. Also, ethical considerations were read to each participant on top of each data collection tool for verbal consent before their responses were captured. Results: A total of 70 health workers participated in the study from all the eight health facilities having a respondent rate of 97.2%. SPSS version 16 was used to analyze the data with majority of respondents being nursing assistants at 45.7%, nurses at 24.3%, porters at 24.3% and health assistants at 5.7%. All the facilities were primary health-care centers of Level II at 75% and III at 25%. The HCWM practices included Display of protocols at a lowly 12.5%, segregation practiced in 87.5% only by separation of sharps from other types of waste produced and open air burning at 87.5% as the major method of waste disposal. Also, all the HFs lacked HCWM plan, committees and none recorded the waste they produced. Knowledge of health workers about the HCWM policy was at 55.7% with those that have got training standing at 44.3%. Correct identification of color codes/containers for waste storage was at an average of 44.8% for all with the best being in sharps at 84.3% and the least of 4.3 % for Blood giving sets. The occupational hazards occurrence was at 42.9% that included cuts 50.0%, pricks 23.3%, splash/spills 20.0% and others at 6.7%. These were commonest on OPD in the afternoon duty shift due to various causes like crude dumping, splashes and other causes, notably fatigue with six cases and uncooperative clients with eight cases. The common actions taken in event of an occupational hazard were investigations and provision of PEP followed with training and display of warning signs. Conclusion and recommendations: The study identified low knowledge and lack of facilities as major hindrances to proper HCWM which may be partly responsible for the occurrence of occupational hazards. Therefore, ADLG health office and MOH should carry out in service training of health workers on HCWM and disseminate protocols on the standard practices. Also, efforts should be made to avail central waste management centers in the district to improve on disposal as open air burning is not an option any more.
Investigation of the Knowledge and Practice of Mothers of Children Under Five on Growth Monitoring:
(International Health Sciences University., 2012-09) Alice, Aol
Growth monitoring, particularly of infants and young children, is widely regarded as an essential element of primary health care (de Onis et al. 2004). Growth monitoring and promotion (GMP) is a nutrition intervention that measures and charts the weight of children from zero to five years of age and uses this information to counsel parents so that they take action to improve child growth (WHO, 1986). The broad objective of the study is to assess the knowledge and practice of mothers of the under five children on growth monitoring and suggest possible solutions. The method or methodology used was a cross sectional descriptive study design which was conducted in Kitgum- District, Labongo –Division in Lamit North and South Parishes. The population sample was 376 and the sampling technique was simple random sampling method. According to the study, significant impressions were made because majority of the respondents 355 (96%) heard about growth monitoring and were able to answer most of the questions appropriately. However, only 14 out of 376 i.e. (4%) of the respondents never knew about growth monitoring. Thus, the awareness of mothers of children under five was good, only few would ignore the need for growth monitoring because of lack of information, inadequate number of health workers to provide the services and inadequate supplies of the equipments in the side of health workers. Despite the knowledge about growth monitoring and the availability of some of the services offered, the study established that minority of the respondents (4.3%) never had the child health cards. This indicated that there were other factors hindering them from going for growth monitoring, lack of information being the main reason and sometimes the mother said even money for transport is a problem hence failure to attend the clinics. Conclusion: For growth monitoring to be effective, there should be regular training, resources availability, supervision, management and evaluation in child health services.
A Study of Lymphatic Filariasis Trend Following the Intervention on Mass Drugs Administration Campaign of 2001 - 2006 in Wawi Division District, Zanzibar.
(International Health Sciences University., 2012-09) Khamis, Salim Mussa
Lymphatic filariasis is a mosquito transmitted parasitic diseases caused by filarial nematodes Wuchereria bancroft.World health Assembly approved a resolution calling for the elimination of lymphatic filariasis as a public health problem (WHA 50.29).As a result this Zanzibar developed a policy to control this disease through mass drug administration. Despite the massive intervention of MDA, some people did not take the recommended doses of ivermectin and albendazole for different reasons varying from poor education, negative cultural attitudes among others. It is thought that this could have affected the intended outcomes of the Mass Administration campaign. Since mass drug administration ended in 2006, it has not been known how the disease burden has changed over time and hence the need for this study. The study was conducted in Wawi Division, Chake chake District, in Zanzibar. The main objective of the study was to establish the trend of lymphatic filariasis occurrence in Wawi division following the Mass drug administration intervention that was carried out between 200 to 2006 so that we could suggest possible solutions should there be evidence of resurgence. A cross sectional study design using both qualitative and quantitative strategies was conducted and this involved 340 respondents, and 15 health workers in the health facilities participated in the study in Wawi division chake chake district, Pemba Island and questioner were used in the study. From the study, some significant findings show that majority of the respondents were ignorant about the cause of LF. 201(59.1%) of the respondents thought LF is a hereditary disease. Although the trend of LF came down between 2001-2006, it will also be noted that no major intervention has been undertaken by the ministry of health to eliminate LF from wawi division since MDA, and there are also no drugs from national up to health facility level as shown in this study. Current records about the trend of LF are not available and this has proved to be one of the limitations of this study. However on a positive note, the health seeking behavior of the respondents was positive with 83.2% of respondents seeking for health care from the public hospital. Therefore Ministry of Health Zanzibar should go on a health promotion and education drive. This will enable the community to gain more knowledge about the causation of lymphatic filariasis. This knowledge about causation will in turn help to reduce the prevalence of lymphatic filariasis. Secondly the ministry of health should prioritize lymphatic filariasis in their budget. This will enable them to purchase and provide drugs and other resources for the treatment and management of lymphatic filariasis at national, district and health facility level. In addition to the above, the ministry of health should come up with specific interventions targeting lymphatic filariasis. These can include indoor residual spraying, mass drug administration, use of larvicides and surveillance system.
Prevalence of Tobacco Uses and Risk Factors Among Secondary School Students in Zanzibar:
(International Health Sciences University., 2012-09) Faki, Haji Faki
In Zanzibar, minimal information is available on tobacco use and its risk factors among Secondary school students that have made it difficult to establish effective control intervention in the country. Therefore, cross-sectional study was conducted among secondary school students in Urban District of Zanzibar. This was done with the hope that the study findings would reveal the actual prevalence of tobacco use and factors influencing/exposing adolescents to use this harmful product. A total of 305 Secondary School students were randomly selected from seven Urban Schools and interviewed to determine the proportion of tobacco use, types of tobacco products used, initial age of tobacco use and socio-economic factors exposing them to use tobacco product. The results show that, the overall prevalence of tobacco product use among Secondary school students was 29(9.51%). Among the male respondents, more than three quarter had used a tobacco product, whereby on average 4.59 times higher (15.72%) than the female counterparts (3.42%). Majority of students (5.9%) could not recall the last time they used a tobacco product, 2.3% of respondents had used a tobacco product one year ago, while one percent had used a tobacco product within one week and one month before the study. This forms the current users of tobacco product to be 2.9%. The most popular brand of tobacco products used by the respondents were cigarette (8.5%), followed by kuberi (1.3%) and Tulsi that was found to be the least used product among others. Of those reported smoking cigarettes (58.6%) they had not smoked 30days prior study, 3.4% had smoked 2-5 cigarette per day while 37.9% not sure how many cigarette they smoke. Of those who reported ever using tobacco product, 44.4% they used it because they wish to have an experience of smoking. In addition the study findings using the logistic regression model revealed that, the use of tobacco among secondary student in this study associated with several factors. Ever use of tobacco product was highly significantly associated with male sex. The results indicate that the odds of male using tobacco product were 4.5 times the odds of female that use tobacco product (OR 4.59, 95% CI; 1.55-13.57). The use of tobacco was found to have statistical significance with increase in the age among secondary student. The results indicate that the odds of 18 years or older using tobacco product were 0.71 times higher of students who were 13 year of age (OR 0.71; 95% C.I; 0.5–1.01). Being African origin, become an important variable for tobacco use among secondary students. The odds of African origin who use tobacco product were 0.13 times of Indians (OR 0.13; 95% C.I; 0.04–0.38). Ever use tobacco product among students has statistical association with friendship. The odds of ever use tobacco with the influence of close friends were 0.21 times the odds of not having close friends (OR 0.21; 95% CI; 0.08–0.52). In conclusion, the study findings shade light on the fact that tobacco-related product use is becoming more popular among adolescents in Zanzibar. Thus, this study inculcates participation of adolescents in the planning and implementation health education programs against tobacco-related product usage at an early age to promptly prevent its adoption and use. This program will not only increase their knowledge about the importance of preventing tobacco-related product use but also mitigate its long term effects like lung cancer and increase risk to the development of tuberculosis in Zanzibar. In addition strict guidelines on tobacco-related product use should be reinforced by the Ministry of Health Zanzibar and other stakeholders by monitoring of the enforcement of the ban on tobacco usage so as to ensure that the importation and distribution of the tobacco products into Zanzibar is minimised.
Factors Influencing Utilization of Health Care Services Among the Elderly in Akayere Sub-County, Serere District - Uganda.
(International Health Sciences University., 2012-09) Okello, Emmanuel
Over the past century, life expectancy for both men and women has increased drastically from forty to sixty years and above. This is attributed to a drift from preventive to clinical medicine, the advent of antibiotics and the advancement of medical technology however the increase in life expectancy among the older persons has consequently been coupled with the manifestation of lifestyle and chronic diseases thus making the elderly prone to ill health. This was a descriptive cross sectional study conducted in Kyere Sub County and a total of 256 older persons were interviewed. 256 respondents were interviewed and responses recorded in questionnaires the collected raw data was coded, entered into the excel spread sheet and analyzed using Statistical Package for Social Science version 16.0 (SPSS). The results indicate that the magnitude of the older persons utilizing health care services is 57.03 percent and it was noted that 94 percent of respondents said that Family had a significant influence in the utilization of health care services. Other factors like Religion with 77.34 percentage and Peer influence with a 28.91 percentage although insignificant were noted to influence uptake of health care services. The attitude of health care workers is an important variable in determining the utilization of health care with 88.28 respondents saying it was good while 11.72 percent said it was bad. Measures required to increase the uptake of health care services by the older persons include; Carrying out a needs assessment among the elderly, mainstreaming the existing training curriculum for health workers at all levels in order to roll out specialists who can tackle health ailments of the elderly and provision of drugs for the treatment of health ailments that affect the elderly. Establish nursing homes for the elderly to bridge the gap of filial responsibility for the elderly persons with no children and special outreach programme on good health practices targeting the elderly should be promoted. Income generating activities should also be promoted so as to break the viscous cycle of poverty. In conclusion, more research needs to be done on factors affecting the utilization of health care services among the elderly because literature is so scarce in Uganda.
The Influence of Cultural Factors on Choice of Family Planning Methods :
(International Health Sciences University., 2012-09) Ejang, Joan
In this study, the researcher undertook to investigate the influence of cultural factors on the choice of family planning methods. High population growth rate has become a global issue that needs to be addressed urgently. One way through which the issue should be addressed is by looking at culture in relation to contraceptive use among different populations and in this study, the researcher looks at Namuwongo Parish in Makindye Division, Kampala District. The objectives of the study were; to identify the cultural factors surrounding Family Planning, to establish the determinants of choice of Family Planning methods, to find out the link between cultural factors and choice of Family Planning methods and to identify other determinants of choice of family planning methods. A cross sectional study was conducted using questionnaires and interview guides to collect data between June 2012 and September 2012. Data from men and women aged between 18 to 45 years residing in Namuwongo Parish was collected. 246 study participants were interviewed using systematic sampling where one participant from every 3rd household was selected for the interview. Data was analyzed according to each study objective using SPSS software. Frequency tables, bar graphs and pie charts were used to present the data. Bivariate analysis was used to assess the relationship between the dependent variable and independent variables. This also involved computation of Chi-square test for the significance of association. Findings from the study showed that despite modernization, culture has a significant influence on people’s choice of family planning methods and is one of the contributing factors of the low contraceptive utilisation in Namuwongo Parish. The researcher put across several recommendations on how to increase utilisation of family planning services in Namuwongo Parish and also recommended further research to establish the level of significance of the other factors on contraceptive choice.
The Influence of Medical Staffing Levels on the Management of Patients :
(International Health Sciences University., 2012-09) Taban, Patrick
The study was about the influence of medical staffing levels on the management of patients: A case study of HC IIIs in Moyo district. The specific objectives were: to determine the capability of the medical staff to manage the number of patients that turns up on a day to day basis, to investigate the ability of medical staff in utilizing available equipment in HC IIIs of Moyo district, to establish the capacity of the medical staff in managing cases of illness mandated to HC IIIs. A cross sectional study was conducted which involved quantitative and qualitative data collection methods. Out of 72 target population of medical workers, a sample size of 61 was studied and focus group discussions were also conducted to patients who have been attended in these health facilities. The data was analyzed using SPSS version 16.0 software and excel and was presented in narrative summary, tables, bar charts and pie charts. The key findings of the study indicated that attending to all patients, minimizing waiting time, providing appropriate treatment, provision of patient counseling and minimizing number of deaths at health facility were all compromised by the inadequate number of medical staff. On average, all the eight HC IIIs in Moyo District had 9 trained health staffs each, which is less than the required 15 trained health staff (HSSP I, 1999). In the study, majority of the respondents agreed that all the five components of patient management were affected by low level of qualification of medical staff, majority of the respondents 33 (54.1%) commented that qualifications of the medical staff of HC IIIs in Moyo District were inadequate and greater numbers of the medical staff in HC IIIs of Moyo 12 (16.7%) were nursing assistants who mainly do the work of nurses and midwives. Majority of the respondents also said that all components of patient management were affected by cadres (skill mix) of medical staff in HC IIIs of Moyo District with greater number 46 (75.4%) further reporting that skill mix of the medical staff was inadequate. Level of experience was also reported by majority of the respondents to affect all the components of patient management with most of them 44 (72.1%) further stating that level of experience of the medical staffs in HC IIIs of Moyo District was adequate. Further findings indicated that majority of the health workers were able to utilize most of the equipments in HC IIIs of Moyo except manual vacuum aspirator, implant inserter, manual vacuum extractor and ophthalmoscope. There was also evidence that the medical staffs had gaps in managing conditions and diseases mandated to HC III facilities. Basing on the above findings, it is recommended that the MoH, Public Service Commission, MoFPED and other stake holders should recruit and retain skilled medical staffs to meet the staffing norm of Uganda Local Government, create opportunities and offer sponsorship for further education and training of middle health care workers to manage cases beyond their original capacity and finally to prioritize and support training of laboratory technicians, midwives, clinical officers, nurses and recruit them to fill the existing gaps in HC III facilities of Moyo and other districts with the same staffing gaps.
Alcohol Uptake and Risky Sexual Behaviours Among Adolescents :
(International Health Sciences University., 2012-09) Oboma, Olga Slain
This was a study to determine the relationship between alcohol uptake and risky sexual behaviors among adolescents in Kamwokya slum a suburb of Kampala. The major objective of the study was to determine the relationship between alcohol uptake and risky sexual behaviors, and the specific objectives were: To determine the prevalence of alcohol uptake among adolescents in Kamwokya. To identify the risky sexual behavior among adolescents of Kamwokya. To establish the relationship between alcohol uptake and risky sexual behavior among adolescents of Kamwokya. Methodology: a cross-sectional descriptive study was carried out in Kamwokya slum, Kampala district with a catchment population of approximately 75,000 adolescents. A clustered random sampling was used, followed by simple random sampling of eligible adolescents so as to gain the proportionate sample size. The target sample size was 138 respondents. Quantitative data was collected using a structured questionnaire administered by researchers. Findings: The prevalence of alcohol among adolescents is consistent across a broad spectrum of the adolescent population as well as the risky sexual behavior, Conclusion: Alcohol uptake is strongly associated with risky sexual behavior in the adolescent population of Kamwokya. The recommendations include; need to formulate strategies to enable adolescents make responsible decisions in relation to alcohol consumption and sexual behavior. Further there should be education interventions highlighting the dangers of multiple sexual partners, and use of alcohol before sex.
Knowledge, Attitude and Socio-Economic Factors on HIV/AIDS in the Ugandan Army :
(International Health Sciences University., 2012-09) Oluka, Felix Ronald
Uganda estimates the HIV/AIDS prevalence rates in the UPDF to be between 27% and 30%, more than four times above the national prevalence rate of 6.7%. This trend of HIV transmission indicates possible gaps in the knowledge, and attitude and affects their health behaviour in as regards HIV/AIDS. The researcher therefore sought to carry out a study; Knowledge, Attitude and Socio-Economic factors as regards HIV/AIDS in the Ugandan Army; Case Study: Ghadaffi Army Barracks, Jinja District. The objectives of this research project are to assess levels of knowledge, attitude and socio-economic aspects of soldiers in the Uganda army in as regards HIV/AIDS with the goal of developing new interventions. The research design used in this study was a cross-sectional design that was quantitative and qualitative in nature. This study took place in Ghadaffi Barracks and the population of interest was male and female soldiers aged 18 - 49 years who have been in active service in the last 5 years, and were resident in Ghadaffi army barracks at the time of study. Data were collected through the use of semi-structured interviews with questionnaires and also focus group discussions. The collected data was analyzed using a computer program; Statistical Package for Social Scientists (SPSS) and MS Excel for graphic impression. With all the data collected from the respondents (n =50), and analysis done, a mean score of 57.6 indicates that the members of the Uganda Army are quite knowledgeable about HIV/AIDS. They are aware of its cause (62%), correct means of transmission (86%) signs and symptoms and prevention (87%). A positive attitude to note is that a good percentage (88%) of the soldiers has been tested for HIV/AIDS. However, the study also revealed that there are significant attitudinal and socio-economic aspects of HIV/AIDS among the soldiers. There exists a negative attitude towards those living positively with HIV: (76% Vs24, OR 3.167, X2 =0.254, PV= 0.024). and (44%) feel uncomfortable around a PLWHA. This hints on the existence of other stigma related issues among the soldiers. The study further unveiled that emotional stress that led to the need for company of the opposite sex (for sexual relief) is a significant socio-economic aspect (n=32%, OR=0.471, XÂ²=4.987, PV=0.02). Lastly a regression analysis revealed that duration of service in the army is significant (PV=0.018), indicating that service in the army presents an occupational hazard of HIV/AIDS to its members. Based on the findings, the researcher recommends that targeted information on HIV/AIDS should be provided for all soldiers at various levels of military command, soldiers be engaged more in HIV/AIDS campaigns, implementation of support systems for afflicted soldiers, and the use of soldiers' personal experiences with HIV/AIDS in developing IEC material for HIV/AIDS education in the military.
Factors Influencing the Utilisation of Insecticide Treated Nets (ITNS) in Bungikikungwi Division - Central District, Zanzibar.
(International Health Sciences University., 2012-09) Mwinyi, Issa Khamis
Insecticide treated nets have been proven to reduce malaria transmission, morbidity and mortality rates of malaria in many high endemic countries. Many studies have shown that the use of ITNs is influenced by a number of factors in communities especially in African countries. The objective of this study was to determine factors that influencing ITNs utilization in Bungikikungwi division Central District of Zanzibar. This cross- sectional study was conducted in two villages within Bungikikunwi division from 18th -29th June 2012. The study employed two operational approaches. A qualitative survey was conducted using structured interview involved a total number of 382 respondents. Two focus group discussions were held, invited a total of twelve participants. FDG Guide was prepared in advanced to facilitate the discussion. A random sampling procedure was used to ensure equal representation of the survey subjects, and therefore 382 respondents were interviewed. Data analysis was done using SPSS window version 16.0. Chi square and correlation statistical analysis were used for both categorical and numerical data to measure association between variables. For qualitative data, purposive sampling method was used to select participants of which a recorder did write participants responses accordingly. A tape recorder was used also to collect information generated during the discussion for confirmation reason. The study findings disclose that the proportion of ITNs utilization among study population in the study area is high (95.8%). Community awareness on the utilization of ITNs as a tool for malaria prevention has also been very impressive (99.2%). Proportion of pregnant women who slept under the ITNs were extremely high (97.7%) in the study areas. There was no significant association between the occupational of head of households and ITNs utilization (P=0.879), source of income (P= 0.998), educational level of respondents (P=0.1442). Although the level of ITNs utilization is high in the study area, there is need of support provision on information, education and communication approach from different agents dealing with malaria preventive measures and to sustain the progress achieved.

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