Browsing by Author "Atuhaire, Leonard K."

Now showing 1 - 8 of 8
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    Determining Factors that Influence Household Food Insecurity in Uganda: A Case Study of Tororo and Busia Districts
    (International Journal of Sciences: Basic and Applied Research, 2014) Owino, Abraham Y.; Atuhaire, Leonard K.; Wesonga, Ronald; Nabugoomu, Fabian; Muwanga-Zaake, Elijah S.K.
    Addressing the national food insecurity problem requires an understanding and measurement of food insecurity at micro-level using a wide range of explanatory variables. Measurement of food insecurity is a challenge because it is a multi-faceted latent and continuous phenomenon explained by many variables. This paper examines these variables and applies exploratory factor analysis to identify variables which significantly influence household food insecurity and how they uniquely associate with specific food insecurity factors. Primary data on food availability, access, utilization and coping strategies were collected from 1175 randomly selected rural households in Tororo and Busia Districts of Uganda. Feasibility of exploratory factor analysis was analyzed using Pearson’s correlation coefficient.
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    Interrelationships between early antenatal care, health facility delivery and early postnatal care among women in Uganda: a structural equation analysis
    (Global Health Action, 2020) Atuhaire, Ruth; Atuhaire, Leonard K.; Wamala, Robert; Nansubuga, Elizabeth
    Early medical checkups during and after delivery are key strategies to detect, prevent and treat maternal health concerns. Knowledge of interrelationships between early Antenatal Care (ANC), skilled delivery and early postnatal care (EPNC) is essential for focused and well-targeted interventions. This paper investigated the interconnectedness between maternal health services in Uganda. Objective: This study examines the predictors of interrelationships between early antenatal care, health facility delivery and early postnatal care. Methods: We used a sample of 10,152 women of reproductive ages (15–49), who delivered a child five years prior to the 2016 Uganda Demographic and Health Survey. A generalized Structural Equation Model and STATA 13.0 software were used. Results: Early ANC was a mediating factor for health facility delivery (aOR=1.04; 95% CI=1.01- 1.14) and EPNC (aOR=1.1; 95% CI=1.05-1.26). Increased odds of early ANC utilization was directly associated with: Adult women aged 35-49 (aOR=1.18; 95% CI=1.10-1.35), having completed primary seven (aOR=1.68; 95% CI=1.56-1.84); distance to a health facility (aOR=1.35; 95% CI=1.23-1.73) and costs (aOR=1.85; 95% CI=1.31-2.12) not being a problem, available community workers (aOR=1.06; 95% CI=1.04-1.17), pregnancy complications (aOR=2.04; 95% CI=1.85-2.26) and desire for pregnancy (aOR=1.15; 95% CI=1.07-1.36). Through early ANC utilization, being married (aOR=1.16; (=1.04*1.10)), no distance issues ((aOR=1.40; (=1.04*1.35)) and complications (aOR=2.12; (=1.04*2.04)) indirectly influenced utilization of health facility delivery. Women aged 20-34 (aOR=1.01; (=0.92*1.1)), completing primary seven (aOR=1.85; (=1.69*1.1)) and no cost problems (aOR=2.04; (=1.85*1.1)) indirectly influenced EPNC. Conclusion: Early antenatal care was a mediating factor for health facility delivery and EPNC; and hence, there is need for more focus on factors for increased early antenatal care utilization. Women with higher education and those with no cost problems were more likely to have early ANC utilization, skilled delivery and EPNC; therefore there is need to design and implement policies targeting social and economically disadvantaged women.
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    Regional Differentials in Early Antenatal Care, Health Facility Delivery and Early Postnatal Care among Women in Uganda
    (Journal of Economics and Behavioral Studies, 2021) Atuhaire, Ruth; Wamala, Robert; Atuhaire, Leonard K.; Nansubuga, Elizabeth
    This study aimed at examining regional differentials in maternal healthcare services in Uganda. Using a sample of 1,521 women of reproductive ages (15-49) from Eastern and Western sub-regions of Uganda, and non-linear Oaxaca’ Blinder Multivariate Decomposition method, we assessed differentials in utilization of early antenatal care, health facility delivery and early postnatal care services among the women, henceforth, establishing main predictors of regional inequalities that will enable policymakers to make better evenly interventions and focused decisions. The study reveals that differentials in the utilization of maternal healthcare services are not only hindered by social and economic barriers, but also widespread disparities in the utilization of existing services. Significant differentials were attributed to both variation in women’s characteristics and effects of coefficients. Findings showed that the gap in early antenatal care would reduce on average by 31.6% and 34.7% of differences in availability of community health workers and media exposure respectively, were to disappear. Furthermore, the gap would increase on average by 68.8% and 12.6% in absence of the variation in effects of maternal education, and wealth respectively. The gap in health facility delivery would reduce on average by 24.6% and 37.2% of differences in community health worker availability and media exposure were to disappear respectively and increase on average by 54.9% in the absence of variations in effects of maternal education. The gap in EPNC would reduce on average by 18.5% and 17.17% of differences in maternal education and community health worker availability were to disappear respectively and increase on average by 52.8% and 8.4% in the absence of the variation in effects of maternal education and wealth respectively. Progress towards equitable maternal health care should focus more on strategies that guarantee even distribution of community health workers, broad dissemination of maternal healthcare information and girl child education completion in Uganda.
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    Relationship between socioeconomic status and risk of sexually transmitted infections in Uganda: Multilevel analysis of a nationally representative survey
    (International journal of STD & AIDS, 2019) Anguzu, Godwin; Flynn, Andrew; Musaazi, Joseph; Kasirye, Ronnie; Atuhaire, Leonard K.; Kiragga, Agnes N.; Kabagenyi, Allen; Mujugira, Andrew
    Socioeconomic status (SES) appears to have positive and negative associations with sexually transmitted infection (STI) risk in resource-limited settings, but few studies have evaluated nationally representative data.We assessed multiple SES measures and their effect on STI risk. We conducted a secondary analysis of data from the Uganda Demographic and Health Survey (UDHS 2011). The primary outcome (STI risk) was self-reported STIs and/or symptoms in the prior 12 months. We examined associations between multiple SES measures and STI risk using a mixed-effects Poisson regression model. The results showed that of the 9256 sexually active individuals, 7428 women and 1828 men were included in the analysis. At an individual level, middle wealth quintile and disposable income were associated with STI risk, whereas being in the richest wealth quintile was protective. Residence in wealthier regions (adjusted incidence rate ratio [aIRR] 3.92, 3.62, and 2.75, for Central, Western, and Eastern regions; p<0.01) was associated with increased STI risk. Regional level analysis revealed stochastic variability of STI risk across geographical region (variance 0.03; p¼0.01). The bilateral association between SES and STI risk underscores the need for multi-sectoral interventions to address the upstream effects of poverty on STI risk and downstream effects of STIs on health and economic productivity.
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    Relationship between socioeconomic status and risk of sexually transmitted infections in Uganda: Multilevel analysis of a nationally representative survey
    (International journal of STD & AIDS, 2019) Anguzu, Godwin; Flynn, Andrew; Musaazi, Joseph; Kasirye, Ronnie; Atuhaire, Leonard K.; Kiragga, Agnes N.; Kabagenyi, Allen; Mujugira, Andrew
    Socioeconomic status (SES) appears to have positive and negative associations with sexually transmitted infection (STI) risk in resource-limited settings, but few studies have evaluated nationally representative data. We assessed multiple SES measures and their effect on STI risk. We conducted a secondary analysis of data from the Uganda Demographic and Health Survey (UDHS 2011). The primary outcome (STI risk) was self-reported STIs and/or symptoms in the prior 12 months. We examined associations between multiple SES measures and STI risk using a mixed-effects Poisson regression model. The results showed that of the 9256 sexually active individuals, 7428 women and 1828 men were included in the analysis. At an individual level, middle wealth quintile and disposable income were associated with STI risk, whereas being in the richest wealth quintile was protective. Residence in wealthier regions (adjusted incidence rate ratio [aIRR] 3.92, 3.62, and 2.75, for Central, Western, and Eastern regions; p < 0.01) was associated with increased STI risk. Regional level analysis revealed stochastic variability of STI risk across geographical region (variance 0.03; p = 0.01). The bilateral association between SES and STI risk underscores the need for multi-sectoral interventions to address the upstream effects of poverty on STI risk and downstream effects of STIs on health and economic productivity.
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    Retention and Attrition in Academia: A Time-to-event Analysis
    (Kenya Studies, 2013) Muhwezi, Keneth; Wamala, Robert; Atuhaire, Leonard K.
    An abundance of literature exists regarding retention and attrition of teachers in primary and secondary education levels. This however is not the case with regards to academic staff in universities. Administrative records of 1,486 academic staff recruited at Makerere University in the period 1987–2012 provide a basis for making an assessment of this issue. Duration of university service was modeled in the analysis by characteristics of academic staff (age, gender, and marital status), discipline area, academic qualifications and rank using a Cox regression. In the results, a median duration of service among staff who left the University by December 2012 (4.56 years, range 0.22-23.32) confirms arguments of low retention of academia. Low retention in university service was more likely among young academic staff, those at lower academic ranks and staff with high academic qualifications at the time of recruitment. The findings demonstrate similarities in retention and attrition of teachers in primary, secondary and university levels.
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    Retention of Academia at Makerere University : A Time-To-Event Analysis
    (Voice of Research, 2017) Muhwezi, Keneth; Wamala, Robert; Atuhaire, Leonard K.
    The study investigated the dynamics of the service duration of academic staff at Makerere University basing on the administrative records of 1,486 academic staff at the university, recruited in the period 1987–2012. The period from the date of first appointment to the date of exit was adopted as a measure of the service duration at the university. A time-to-event approach in a Cox model was adopted in the analysis. The results, show that the median duration among academic staff who had left the university service by December 2012 (N = 213) is 4.56 years (range, 0.22–23.32). This figure points to a low retention of academia at the university. The rate of exit from the university service reduces significantly with higher academic ranks and increase in age at the time of recruitment. The findings point to a need to scaleup measures in retaining staff particularly those at lower levels.
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    A structural equation analysis on the relationship between maternal health services utilization and newborn health outcomes: a cross-sectional study in Eastern Uganda
    (BMC pregnancy and childbirth, 2017) Muhumuza Kananura, Rornald; Wamala, Robert; Ekirapa-Kiracho, Elizabeth; Tetui, Moses; Kiwanuka, Suzanne N.; Waiswa, Peter; Atuhaire, Leonard K.
    Neonatal and maternal health services have a bearing on neonatal mortality. Direct and indirect factors affecting neonatal health outcomes therefore require understanding to enable well-targeted interventions. This study, therefore, assessed the interrelationship between newborn health outcomes and maternal service utilization factors. Methods: We investigated maternal health utilization factors using health facility delivery and at least four Antenatal Care (ANC) visits; and newborn health outcomes using newborn death and low birth weight (LBW). We used data from a household cross-sectional survey that was conducted in 2015 in Kamuli, Pallisa and Kibuku districts. We interviewed 1946 women who had delivered in the last 12 months. The four interrelated (Endogenous) outcomes were ANC attendance, health facility delivery, newborn death, and LBW. We performed analysis using a structural equation modeling technique. Results: A history of newborn death (aOR = 12.64, 95% CI 5.31–30.10) and birth of a LBW baby (aOR = 3.51, 95% CI 1. 48–8.37) were directly related to increased odds of newborn death. Factors that reduced the odds of LBW as a mediating factor for newborn death were ANC fourth time attendance (aOR = 0.62, 95% CI 0.45–0.85), having post-primary level education (aOR = 0.68, 95% CI 0.46–0.98) compared to none and being gravida three (aOR = 0.49, 95% CI 0.26–0.94) compared to being gravida one. Mother’s age group, 20–24 (aOR = 0.24, 95% CI 0.08–0.75) and 25–29 years (aOR = 0.20, 95% CI 0.05–0.86) compared to 15–19 years was also associated with reduced odds of LBW. Additionally, ANC visits during the first trimester (aOR = 2.04, 95% CI 1. 79–2.34), and village health teams (VHTs) visits while pregnant (aOR = 1.14, 95% CI 1.01–1.30) were associated with increased odds of at least four ANC visits, which is a mediating factor for health facility delivery, LBW and newborn death. Surprisingly, newborn death was not significantly different between health facility and community deliveries.Conclusions: Attending ANC at least four times was a mediating factor for reduced newborn death and low birth weight. Interventions in maternal health and newborn health should focus on factors that increase ANC fourth time attendance and those that reduce LBW especially in resource-limited settings. Targeting women with high-risk pregnancies is also crucial for reducing newborn deaths.