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Exploring the utilization of postabortion care services and related factors among women at a tertiary health facility in Gulu, Northern Uganda
(Sega Sexual and Reproductive Health Across Africa: Challenges and Opportunities, 2024-10-11) Ayikoru, Jackline; Opee, Jimmy; Bongomin, Felix; Atim, S.Fiona; Pebalo Pebolo, Francis
Background: Abortion-related complications are the third leading cause of maternal mortality in Uganda, accounting
for approximately one-fourth of all maternal deaths. Most are preventable through adequate use of the full package of
postabortion care (PAC) services.
Objective: We aimed to assess the level of utilization of PAC services and the associated sociodemographic, obstetric,
gynecological, and system-related factors at a high-volume tertiary health facility in Northern Uganda.
Design: A cross-sectional survey was conducted among women receiving PAC at the Gulu Regional Referral Hospital
from March 2023 to June 2023. Participants were recruited consecutively and exit interviews were conducted using
structured questionnaires.
Methods: Utilization of PAC was defined as the use of four or more of the following: counseling, emergency treatment,
family planning services, linkage to other sexual and reproductive health services, and community health service provider
cooperation. Modified Poisson regression analysis was used to determine the independent predictors of PAC utilization.
Results: A total of 364 participants were enrolled in the study. Overall, 21.1% (n = 77) of the participants had used four
or more PAC services. Having a supportive partner (adjusted prevalence ratio (aPR): 1.9, 95% confidence interval (CI):
1.19–2.88, p = 0.006), knowledge on PAC services (aPR: 1.7, 95% CI: 1.19–2.48, p = 0.004), low parity (aPR: 2.2, 95% CI:
1.16–4.35, p = 0.016), nulliparity (aPR: 2.4 95% CI: 1.19–4.73, p = 0.014), and provision of privacy(physical privacy during
prescription, counseling, procedures) (aPR: 2.3 95% CI: 1.14–4.47, p = 0.02), were significantly associated with utilization
of PAC.
Overall, only one in five participants utilized four or more PAC services. Use of four or more PAC services was
significantly associated with women having a supportive partner, knowledge of PAC services, low parity, nulliparity, and
provision of privacy while receiving PAC services.
Conclusion: Approaches such as advocating male partner involvement, bridging the knowledge gap through health
education, and promoting respectful care may improve the utilization of PAC services.
Microfinance credit terms and the performance of women-owned enterprises in Obongi district
(Gulu University, 2024-04) Abdullai Sebbi Ajagason
The study investigated the effect of Microfinance Credit Terms on the Performance of Women –Owned Enterprises in Obongi District, West Nile Region, Uganda . Specifically, the study objectives were, to examine themicrofinance credit terms issued to women-owned enterprises, to examine the status of performance of women- owned enterprises, to investigate the relationship between credit terms and performance of women-owned enterprises, to determine the relationship between management policy and performance of Women-owned enterprises. The study adopted a descriptive and cross sectional study design supported by qualitative and quantitative approaches. Sample size of 133 respondents was considered. Questionnaire was used to generate data which was analyzed and presented using SPSS. Qualitative data was analyzed using thematic analysis Results show that Performance of women-owned enterprises in Obongi District was average. The qualitative analysis revealed that the overall performance of women-owned ventures in the district is not exceptional. This suggests that there is room for improvement and intervention to enhance the performance of these enterprises. Furthermore, Micro-finance credit terms are stringent and unfavorable: The qualitative findings indicate that the current micro-finance credit terms are perceived as stringent and unfavorable for women-owned enterprises.This suggests that the existing credit terms may pose challenges and constraints for these businesses in accessing and utilizing financial resources effectively. The study recommends that Microfinance Institutions should review and revise microfinance credit terms. This is so because the study indicates that the current credit terms are stringent and unfavorable for women-owned enterprises. It is recommended to review and revise these terms to make them more favorable and accommodating for women entrepreneurs. This may involve considering lower interest rates, flexible repayment periods, and other terms that better align with the specific needs and constraints of women-owned businesses. The study concludes that an emphasis should be put on interventions and policy changes to improve the performance of women-owned enterprises in Obongi District. This includes revising micro-finance credit terms, addressing high interest rates, promoting flexible repayment periods, and implementing supportive management policies. These measures can contribute to creating a more enabling environment for women entrepreneurs and enhance the overall performance and sustainability of their ventures.
Efficacy of the Gulu University Reproductive Health Simulation Training for final year medical students and interns: a before-and-after study
(Therapeutic Advances in Reproductive Health, 2024-04-09) Pebalo Pebolo , Francis; Okot, Jerom; Bongomin , Felix; Awor, Silvia; Arwinyo, Baifa; Ojara, Sande; Opee, Jimmyy; Jackline, Ayikoru; Ssennuni, Eric; Ouma, Simple
Background: Reproductive health emergencies, such as postpartum hemorrhage, contribute significantly to maternal and neonatal morbidity and mortality in Uganda due to knowledge and skills gaps. Medical interns, intern midwives, and nurses are crucial as frontline healthcare workers in responding to these emergencies. Our proposed hands-on strategy involves comprehensive simulation-based training (SBT) to equip these healthcare workers with the essential knowledge to manage common reproductive health emergencies and procedures in the country. Objectives: The study aimed to assess the effectiveness of comprehensive SBT in improving the knowledge of interns and fifth-year medical students on reproductive health emergencies and procedures at Gulu University and its Teaching Hospitals in Uganda. Design: A before-and-after study. Methods: A 4-day SBT was conducted for fifth-year medical students and interns (nurses, midwives, and doctors) at Gulu University Teaching Hospitals, focusing on reproductive health emergencies. Pre- and post-tests with 40 multiple-choice questions were used to evaluate knowledge enhancement, the scores were summarized as medians and interquartile ranges. Paired sample t-tests was used to test the difference in pre- and post-test scores. Independent sample t-tests compared median post-test results between interns and students, with a p-value
Fast-growing exotic tree species as fuelwood alternative for refugees and host communities in Northern Uganda
(Research Square, 2022-06-15) Anywar, Decimon; Shaban, Kato Stonewall; Labeja, Richard Louis; Loki, Robert Okongo; Okello, Collins
The high demand for firewood and charcoal has exerted high pressure on the indigenous trees in Uganda. Communities believe that the indigenous trees are better fuel sources despite limited evidence to support this claim.
This study was carried out in 2021 to evaluate the fuelwood properties of selected indigenous tree species in comparison to three exotic tree species that have been promoted for use by refugees and host communities in Lamwo District of Northern Uganda. Wood samples were collected from three different locations from the study area in Lamwo District and transported to Gulu University for laboratory analysis of their physical and chemical properties. Data were analysed using one way analysis of variance (ANOVA) at 5% level of confidence and the means were separated using Tukey HSD test. Results showed that moisture content, fixed carbon, volatile matter, and Fuel Value Index (FVI) did not significantly vary among the indigenous and exotic tree species. Fuel value index was observed to be negatively correlated with moisture content of the wood, implying both species’ categories retard in fuel quality when their moisture contents increases. Overall, the results show that there were no significant differences in the FVI of all the indegeneous and exotic tree species investigated in this study. It is recommended
that fast-growing exotic species such as Eucalyptus grandis, Caliandra calothyrsus, and Senna siamea that are 22
grown in the region be promoted to ensure regeneration and reduction of pressure on the use of natural forest.
A One Health approach toward the control and elimination of soil-transmitted helminthic infections in endemic areas
(IJID One Health, 2024-04-25) Lapata, Jolly Joe; Opee, Jimmyy; Apio, Monica Clara; Akello, Susan; Lakop Ojula , Christine; Onekalit, Robert; Oumo, Joseph Francisa ,; Lalweny , Dorah; Latigo , Katerega J.P; Lebuc , Sarah; Ochola, Emmanuel; Bongomin, Felix
Soil-transmitted helminths (STHs) pose significant health challenges, particularly in developing countries. Over 2 billion people are estimated to have been infected with at least one STH species. These parasites rely on the soil for part of their life cycle and are transmitted to humans through ova ingestion or skin penetration. Key risk factors include poor water, sanitation, hygiene practices, limited healthcare access, and poverty. Globally, STHs are primarily controlled through chemo-preventive deworming of high-risk groups in moderate (where prevalence of STHs is between 20 % and 50 %) to highly endemic areas (prevalence > 50 %). Despite the use of deworming to control the STHs in endemic areas, infections still occur. The aim of this article is to explore the potential for enhancing STH control and elimination as Neglected Tropical Diseases (NTDs) in endemic areas through an integrated approach—the One Health approach. The current control program has a single strategy of chemoprophylaxis; in the integrated approach to control of STHs, the parasite control strategies besides being based on the epidemiology of the parasite (endemicity), also include strategies based on the biology (transmission cycle) of the parasites and human behavior patterns in endemic areas. Through the involvement of local communities, healthcare authorities, and stakeholders, participatory approaches foster collaborative efforts to devise and implement control measures. By integrating this integrated approach into existing healthcare and educational initiatives, more effective results can be achieved. The promotion of health education, clean water access, improved sanitation, and hygiene awareness can further enhance control strategies and reduce STH prevalence sustainably. Here, we highlight the benefits of adopting an integrated (One Health) approach to tackle STHs in endemic areas. Through community empowerment and multi-sectorial collaboration, we can strengthen our collective efforts to combat STHs and alleviate the burden of these NTDs.