Browsing by Author "Aanyu, Christine"

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    COVID-19 vaccination, perceptions about the vaccine and willingness to take the vaccine among unvaccinated individuals at two Ugandan border points of entry
    (BMC Public Health, 2024) Matovu, Joseph K. B.; Nuwematsiko, Rebecca; Aanyu, Christine; Tabwenda, Lilian; Okade, Tom; Musoke, David; Buregyeya, Esther
    A recent systematic review shows high COVID-19 vaccine effectiveness in fully-vaccinated people in Africa. However, vaccine uptake has varied across populations. We assessed the uptake, perceptions of and willingness to take the COVID-19 vaccine among unvaccinated individuals at two Ugandan border points of entry. Methods This was a cross-sectional quantitative study conducted at Malaba and Mutukula points of entry into Uganda between February and March 2023. We targeted people living in, working at, or transiting through the two points of entry, including truck drivers, point-of-entry customs officers and female sex workers, market vendors, among others. Data were collected on socio-demographic characteristics, vaccine uptake, perceptions and willingness to take the vaccine among unvaccinated individuals. We computed descriptive statistics and determined the factors associated with uptake of and willingness to take the vaccine using a modified Poisson regression model. Data analysis was conducted using STATA statistical package (version 14.0). Results Of the 854 respondents, 50% (n = 427) were from Mutukula. Overall, 80.3% (n = 686) of the respondents reported that they had received at least one vaccine dose; no booster doses were reported. Respondents perceived that the vaccine was efficacious against COVID-19. COVID-19 vaccine uptake was associated with age-group 35–44 years [adjusted Prevalence Ratio [aPR] (95%CI) = 1.13 (1.01, 1.27)] or 45 + years [aPR (95%CI) = 1.19 (1.07, 1.33)]; being a truck driver [aPR (95%CI) = 1.16 (1.04, 1.29)] or health worker [aPR (95%CI) = 1.18 (1.05, 1.32)]; and the belief that the COVID-19 vaccine is protective against COVID-19 [aPR (95%CI) = 1.32 (1.10, 1.58)]. Nearly 60% of unvaccinated respondents (n = 99) were willing to take the COVID-19 vaccine. Willingness to take the vaccine was associated with the belief that one can contract the coronavirus if not vaccinated [aPR (95%CI) = 3.67 (1.90, 7.10)] or the community was at risk of COVID-19 [aPR (95%CI) = 1.86 (1.33, 2.62)]. COVID-19 vaccine uptake was high in this setting while nearly six out of every ten unvaccinated individuals were willing to take the vaccine. Our findings lend credence for ongoing vaccination efforts at points of entry to contain the importation of new COVID-19 variants into the country.
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    Designing for Scale and taking scale to account: lessons from a community score card project in Uganda
    (International journal for equity in health, 2021) Ekirapa Kiracho, Elizabeth; Aanyu, Christine; Apolot, Rebecca Racheal; Namusoke Kiwanuka, Suzanne; Paina, Ligia
    Planning for the implementation of community scorecards (CSC) is an important, though seldom documented process. Makerere University School of Public Health (MakSPH) and Future Health Systems Consortium set out to develop and test a sustainable and scalable CSC model. This paper documents the process of planning and adapting the design of the CSC, incorporating key domains of the scalable model such as embeddedness, legitimacy, feasibility and ownership, challenges encountered in this process and how they were mitigated. Methods: The CSC intervention comprised of five rounds of scoring in five sub counties and one town council of Kibuku district. Data was drawn from ten focus group discussions, seven key informant interviews with local and sub national leaders, and one reflection meeting with the project team from MakSPH. More data was abstracted from notes of six quarterly stakeholder meetings and six quarterly project meetings. Data was analyzed using a thematic approach, drawing constructs outlined in the project’s theory of change. Results: Embeddedness, legitimacy and ownership were promoted through aligning the model with existing processes and systems as well as the meaningful and strategic involvement of stakeholders and leaders at local and sub national level. The challenges encountered included limited technical capacity of stakeholders facilitating the CSC, poor functionality of existing community engagement platforms, and difficulty in promoting community participation without financial incentives. However, these challenges were mitigated through adjustments to the intervention design based on the feedback received. Conclusion: Governments seeking to scale up CSCs and to take scale to account should keenly adapt existing models to the local implementation context with strategic and meaningful involvement of key legitimate local and sub national leaders in decision making during the design and implementation process. However, they should watch out for elite capture and develop mitigating strategies. Social accountability practitioners should document their planning and adaptive design efforts to share good practices and lessons learned. Enhancing local capacity to implement CSCs should be ensured through use of existing local structures and provision of technical support by external or local partners familiar with the skill until the local partners are competent.
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    Maternal and newborn health needs for women with walking disabilities; “the twists and turns”: a case study in Kibuku District Uganda
    (International journal for equity in health, 2019) Apolot, Rebecca R.; Ekirapa, Elizabeth; Waldman, Linda; Morgan, Rosemary; Aanyu, Christine; Mutebi, Aloysius; Nyachwo, Evelyne B.; Seruwagi, Gloria; Kiwanuka, Suzanne N.
    In Uganda 13% of persons have at least one form of disability. The United Nations’ Convention on the Rights of Persons with Disabilities guarantees persons with disabilities the same level of right to access quality and affordable healthcare as persons without disability. Understanding the needs of women with walking disabilities is key in formulating flexible, acceptable and responsive health systems to their needs and hence to improve their access to care. This study therefore explores the maternal and newborn health (MNH)-related needs of women with walking disabilities in Kibuku District Uganda. Methods: We carried out a qualitative study in September 2017 in three sub-counties of Kibuku district. Four In-depth Interviews (IDIs) among purposively selected women who had walking disabilities and who had given birth within two years from the study date were conducted. Trained research assistants used a pretested IDI guide translated into the local language to collect data. All IDIs were audio recorded and transcribed verbatim before analysis. The thematic areas explored during analysis included psychosocial, mobility, health facility and personal needs of women with walking disabilities. Data was analyzed manually using framework analysis. Results: We found that women with walking disabilities had psychosocial, mobility, special services and personal needs. Psychosocial needs included; partners’, communities’, families’ and health workers’ acceptance. Mobility needs were associated with transport unsuitability, difficulty in finding transport and high cost of transport. Health facility needs included; infrastructure, and responsive health services needs while personal MNH needs were; personal protective wear, basic needs and birth preparedness items. Conclusions: Women with walking disabilities have needs addressable by their communities and the health system. Communities, and health workers need to be sensitized on these needs and policies to meet and implement health system-related needs of women with disability.