Browsing by Author "Auma, Anna Grace"

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    Is the 14% cesarean section rate in Gulu Regional Referral Hospital justifiable?
    (. PAMJ Clinical Medicine, 2021-03-26) Pebolo, Francis Pebalo; Baguma, Steven; Auma, Anna Grace
    Worldwide, cesarean section (CS) rates haveincreased tremendously in recent years, especially among high-income countries, raising concernsabout the over-utilization of CS without added benefits, and in the sub-Saharan African region, therate is at its lowest (7.3%). In Uganda, the CS rate stands at 6% and is seen to be higher (11%) among first-order births indicating a high incidence of primary CS. Despite the low rate of CS in Uganda,there are massive gaps in the provision of obstetric procedure with some women receiving unnecessary surgeries, and the facility-based CS rate is projected to increase to 32% by end of 2021. Notwithstanding the increasing facility rates of CS, Gulu Regional Referral Hospital (GRRH) rate has remained low in the years 2017-2019, with lower levels maternal mortality ratio and fresh stillbirths´ rates compared to the national average. Prolonged labor is one of the commonest indications for primary CS accounting for more than 50% among nulliparous women and this is linked to progress of labor usually measured using cervical dilatation. World Health Organization (WHO) recommended a change in cervical dilatation from 4cm to 5cm as a threshold for the active phase of the first stage of labor, as away to reduce unnecessary labor intervention including the CS. Lack of standard reporting tools such as the WHO Robson´s ten group classification in Uganda make comparisons of CS rate between/within facility/facilities worrisomely difficult.
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    Partnering to Improve Mentorship Capacity for Ugandan Reproductive Health Researchers: Program Description and Evaluation
    (The American Journal of Tropical Medicine and Hygiene, 2023-11-20) Buser, Julie M.; August, Ella; Jacobson-Davies, Faelan E.; Bongomin, Felix; Kumakech, Edward; Gray, Rachel; Pebolo, Pebalo Francis; Auma, Anna Grace; Endale, Tamrat; Smith, Yolanda R.
    Mentorship is essential to health researchers in achieving their full potential and advancing public health. In most low-resource settings, there is a paucity of training on how to be a successful mentor. The Center for International Reproductive Health Training at the University of Michigan conducted and evaluated a workshop at two universities in Uganda for mentors of new reproductive health research grant awardees. The program aimed to strengthen mentors’ mentorship skills and to identify ways to foster institutional support for mentoring. Mentors rated their post-training skills using a 5-point Likert scale (not skilled to extremely skilled) immediately and 3 months after the training. Ten of 19 mentors who participated in the training completed the evaluation. The majority were 41 to 50 years old, male, midcareer faculty. Immediately after the training, mentors rated themselves (mean 6 SD) highest in knowledge of research ethics (4.4 6 0.5), fostering independence in mentees (4.3 6 0.9), and understanding the benefits of mentoring (3.9 6 1.1). Mentors felt least confident in fostering institutional change to support mentorship (3.3 6 0.8), communication (3.5 6 0.5), and overcoming adversity (3.5 6 0.8). The two most important things the mentors learned were how to appreciate and manage diversity and how they can benefit from mentorship. Barriers to mentoring that persisted after the program ended included lack of time and institutional resources. Enhancing mentorship training opportunities will foster a generation of scientists who are more supported, skilled, and productive in research, leading to better reproductive and public health outcomes in their communities.
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    Polycystic ovarian syndrome: diagnostic challenges in resource-poor settings (Ugandan perspectives)
    (PAMJ Clinical Medicine., 2021-01-29) Pebolo, Francis Pebalo; Auma, Anna Grace; Alobo, Gasthony
    Polycystic ovarian syndrome is the most common cause of anovulatory infertility accounting for up to 40% of the reasons for visiting a doctor. The Ugandan government has recognized infertility as a major problem affecting over five million people, yet polycystic ovarian syndrome is not included in the Ugandan Clinical Guidelines, hence it´s not part of the Uganda minimum healthcare package. Lack of guidelines means diagnosis is a challenge and many cases have delayed or no diagnosis. Early diagnosis is good for awareness of associated risks such as infertility, dysfunctional uterine bleeding,endometrial cancer, obesity, diabetes, dyslipidemia, hypertension, and cardiovascular diseases. Clinical laboratories are handy in the diagnosis as well as follow-up of PCOS cases and in most rural settings, these are lacking, confounded by the lack of skilled frontline workers such as gynecologists and reproductive endocrinologists