Faculty of Medicine
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Browsing Faculty of Medicine by Author "Akello, Harriet"
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Item Exploring the utilization of postabortion care services and related factors among women at a tertiary health facility in Gulu, Northern Uganda(Sega Publisher Sexual and Reproductive Health Across Africa: Challenges and Opportunities, 2024-10-11) Ayikoru, Jackline; Opee, Jimmy; Bongomin, Felix; Akello, Harriet; Atim, S.Fiona; Pebalo Pebolo, FrancisBackground: 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.Item “We provide the methods to others but we don’t use the methods ourselves”: challenges with utilization of modern contraception among Female Healthcare Workers at two tertiary teaching hospitals, Northern Uganda(Contraception and Reproductive Medicine, 2024-10-31) Opee, Jimmy; Opiro, Keneth; Manano, Priscilla; Sikoti, Margret; Ayikoru, Jackline; Akello, Harriet; Laker, Fiona Gladys; Wolters, K. Maria; Awor, Silvia; Pebalo Pebolo, Francis; Bongomin, FelixBackground Female Healthcare Workers (FHCWs) play a crucial role in advocating for, delivering modern contraceptive methods (MCM) to reproductive-age women and potential users. Despite the high frequency of women seeking healthcare annually, less than half receive adequate contraceptive counseling and services. Investigating FHCWs’ adherence to these practices and understanding the obstacles they encounter is essential. This study aimed to explore challenges with utilization of MCM among FHCWs at the two tertiary teaching hospitals in Northern Uganda. Methods We conducted a descriptive, cross-sectional study employing a qualitative approach at St. Mary’s Hospital Lacor (SMHL) and Gulu Regional Referral Hospital (GRRH), Northern Uganda. Qualitative data were explored using the principles of descriptive phenomenology to gain deeper insights into the experiences of twenty (20) FHCWs. Results Findings revealed various challenges faced by FHCWs, including patient barriers such as religious beliefs, contraceptive myths, fear of side effects, and provider barriers like lack of knowledge, training, and discomfort. Additionally, health system barriers like limited time and competing priorities were identified. Conclusion Female Healthcare workers experience challenges with utilization of MCM. Efforts should focus on enhancing contraceptive services, particularly in faith-based facilities and among married individuals. Besides, addressing perceived barriers at the patient, provider, and system levels through comprehensive health education, ensuring method availability, and provider training is imperative.Item “We provide the methods to others but we don’t use the methods ourselves”: challenges with utilization of modern contraception among Female Healthcare Workers at two tertiary teaching hospitals, Northern Uganda(BMC Contraception and Reproductive Medicine, 2025-10-31) Opee, Jimmy; Opiro, Keneth; Manano, Priscilla; Sikoti , Margret; Ayikoru, Jackline; Akello, Harriet; Laker, F.Gladys; Wolters, K.Maria; Awor, Silvia; Pebalo Pebolo, Francis; Bongomin, FelixBackground Female Healthcare Workers (FHCWs) play a crucial role in advocating for, delivering modern contraceptive methods (MCM) to reproductive-age women and potential users. Despite the high frequency of women seeking healthcare annually, less than half receive adequate contraceptive counseling and services. Investigating FHCWs’ adherence to these practices and understanding the obstacles they encounter is essential. This study aimed to explore challenges with utilization of MCM among FHCWs at the two tertiary teaching hospitals in Northern Uganda. Methods We conducted a descriptive, cross-sectional study employing a qualitative approach at St. Mary’s Hospital Lacor (SMHL) and Gulu Regional Referral Hospital (GRRH), Northern Uganda. Qualitative data were explored using the principles of descriptive phenomenology to gain deeper insights into the experiences of twenty (20) FHCWs. Results Findings revealed various challenges faced by FHCWs, including patient barriers such as religious beliefs, contraceptive myths, fear of side effects, and provider barriers like lack of knowledge, training, and discomfort. Additionally, health system barriers like limited time and competing priorities were identified. Conclusion Female Healthcare workers experience challenges with utilization of MCM. Efforts should focus on enhancing contraceptive services, particularly in faith-based facilities and among married individuals. Besides, addressing perceived barriers at the patient, provider, and system levels through comprehensive health education, ensuring method availability, and provider training is imperative. Keywords Utilization, Modern contraception methods, Female healthcare workers, Gulu University Teaching Hospitals, Northern Uganda