Browsing by Author "Awor, Silvia"

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    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
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    “I Use Strawberry Flavoured Condoms during My Periods”:
    (MDPI, 2023-08-28) Bongomin, Felix; Kibone, Winnie; Pebalo, Francis Pebolo; Laker, Fiona Gladys; Okot, Jerom; Kaducu, Felix Ocaka; Madraa, Grace; Labongo Loum, Constantine Steven; Awor, Silvia; Napyo, Agnes; Musoke, David; Ouma, Simple
    Background: Female sex workers (FSWs) are at a higher risk of contracting and transmitting HIV and other sexually transmitted infections (STIs). We aimed to explore the sexual behaviour, knowledge and attitudes towards STIs, barriers, support and intervention for STI screening. Methods: In this community-based, concurrent quantitative–qualitative, exploratory mixed-methods study, we administered 87 semi-structured quantitative and six in-depth interviews to purposively select FSWs in Gulu City, Uganda. The qualitative methodology was based on descriptive phenomenology. Results: The quantitative study included 87 FSWs, with a median age of 28 years. Overall, 87.4% (n = 76) participants reported condom use during their last sexual encounter. Eighty-three (95.4%) participants were aware of their HIV status, with 6% (n = 5) reporting being HIV-positive. Seventy-six (87.4%) participants reported contracting at least one STI during sex work. In addition, 66.7% (n = 58) of the participants reported being screened for STIs in the past three months, with vulvovaginal candidiasis (55.3%, n = 42) and syphilis (32.9%, n = 25) being the most common STIs. However, only 2.3% (n = 2) of the participants reported current STIs symptoms. In the qualitative study, the main themes encompassed sexual behaviour, including condom-use negotiation strategies and challenges, as well as screening facilitators and barriers. Condom-use negotiation tactics involved leveraging healthrisk information, increased charges for unprotected sex, and outright refusal. Complex challenges included limited agency in promoting safe sex due to economic reliance, vulnerability to violence, and difficulties in controlling the sexual environment. Facilitators for regular screening included social influences, emotional relief, established testing habits, and accessible clinics, while barriers encompassed cost, stigma, doubts about test accuracy, and inconvenient clinic hours. Conclusions: FSWs face significant vulnerabilities in Gulu City, Uganda, regarding STIs. While encouraging trends such as high HIV awareness and condom usage were observed, persistent challenges in STI screening, negotiation of safe sex practices, and access to prevention and treatment remain evident. To address these concerns, targeted interventions should be developed to enhance STI screening accessibility empower sex workers with effective negotiation skills, and provide comprehensive support for STI prevention and treatment, thereby contributing to improved overall sexual health and well-being among this marginalized population
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    Safety and efficacy of herbal medicines for the management of sickle cell disease in Africa: a systematic review and meta-analysis
    (PAMJ One Health, 2024-12-16) Awor, Silvia; Bongomin, Felix; Kaggwa, Mark Mohan; Pebalo, Pebolo Francis; Kivumbi, Ronald Muganga; Malinga, Geoffrey Maxwell; Ongwech, Acaye; Nnamuyomba, Proscovia; Oryema, Christine; Abola, Benard; Epila, Jackie; Musoke, David
    This systematic review and meta-analysis evaluated the safety and efficacy of herbal remedies used to manage sickle cell disease (SCD) in Africa. Before the advent of western medicine, people depended on herbal medicines for treating different illnesses. Using herbal medicines to sickle cell disease (SCD) is still common in Africa. However, data on the safety and efficacy of any of these remedies are limited. We searched PubMed, Embase, Google Scholar and Web of Science from inception to 11thJanuary 2024 using the keywords "herbal medicine" and "sickle cell" and the name of each of the countries in Africa without language restrictions. We included cross-sectional studies that reported the safety or efficacy of herbal medicine for managing sickle cell disease. Two reviewers assessed all included studies for suitability for inclusion in this review. All included articles were assessed using ROBINS-1, a tool for assessing the risk of bias in non-randomized studies of interventions. We used the randomeffect model to pool the efficacy and safety profiles of the herbal medicines using RStudio version 4.2.2. Overall, we included five studies involving 1,489 individuals with SCD. Of these, 789 (53.0%) used herbal remedies like Aloe barbadensis (Aloe vera), Zingiber officinale (ginger), Cymbopogon citratus (lemongrass), Forever Living products, Golden Neo-Life Diamite International (GNLD) diet supplements and ginseng products. About 22.9% (181 out of 789) of the participants who used herbal remedies reported side effects, while 38.5% (304 out of 789) reported improving their symptoms. There was a high risk of publication bias in the articles included in this review. The pooled adverse effects of the herbal medicines for SCD treatment were 48% lower (Odds ratio: 0.52, 95% confidence interval (CI): 0.26 - 1.05, I²= 82%, p<0.01) while the pooled efficacy of herbal remedies for treating SCD was nearly 100% higher (odds ratio= 2.07, 95% confidence interval 0.99 - 4.32, I²= 78%, p<0.01) among the users than controls. However, these findings were not statistically significant. Our findings indicate no significant difference in the safety and efficacy of herbal medicines among people with SCD who used or did not use herbal remedies. However, the sample sizes of the primary studies were small. Thus, more extensive controlled studies with better-defined endpoints are required to inform the use of herbal medicines in managing SCD in Africa.
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    “We Cure Sickle Cell Disease with Herbs”: Perspectives of Herbal Medicine Practitioners Treating Sickle Cell Disease in the Acholi SubRegion
    (DovePress, Taylor & Francis Group, 2025-07-28) Awor, Silvia; Opee, Jimmyy; Denis Ocaya,; Ocaya, Jimmy; Abola, Benard; Malinga, Geoffrey Maxwell; Oryema, Christine; Arwenyo, Beatrice; Ongwech, Acaye; Musoke, David; Nnamuyomba, Proscovia; Epila, Jackie
    Background: Sickle cell disease (SCD) is a genetic blood disorder that results in the deformation of red blood cells under low oxygen conditions, causing vaso-occlusive crises and severe complications. While hydroxyurea has been introduced as a treatment for SCD, herbal medicines remain widely used across Africa. Northern Uganda has a high SCD prevalence of 20.5%, yet limited research exists on alternative treatment options within local communities. This study aimed to explore the perspectives of herbal medicine practitioners in the Acholi sub-region. Methods: We conducted in-depth interviews between October and December 2024 involving 24 herbal medicine practitioners in the Acholi sub-region, selected through referrals and non-probability snowball sampling. All data collected were recorded, transcribed verbatim, and analyzed using thematic content analysis, and emerging themes were presented. Results: All participants believed herbal medicine could cure SCD, and the majority reported successfully treating patients. However, some practitioners remembered some patients who reported being sick with sickle cell crises many years after the “cure”. “When they report improvement, I stop medication after some time…” thereafter, “I encourage them to go to the hospital, but they do not. They can stay without falling sick for a long time and declare themselves healed”. Findings suggest herbal medicines are commonly used for SCD management in the Acholi sub-region. Most herbal medicine practitioners rely on the hospital diagnoses, although a few can tell who has sickle cell disease by looking at or touching them. A lot of mistrust exists between herbal medicine practitioners, the government, and researchers. This hinders efforts to integrate traditional medicine into mainstream healthcare and limits opportunities for scientific validation. Conclusion: Herbal medicine practitioners believe herbs can treat sickle cell disease; however, further research is needed to investigate the nature of these herbs and their mechanisms of action, thereby facilitating the integration of herbal medicine into conventional care. We discuss some implications of the study for practice and policy
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    “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, Felix
    Background 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.
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    “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, Felix
    Background 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