Browsing by Author "Barageine, Justus Kafunjo"

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    “I am Alone and Isolated”: A Qualitative Study of Experiences of Women Living with Genital Fistula in Uganda
    (BMC women's health, 2015-09-10) Barageine, Justus Kafunjo; Beyeza-Kashesya, Jolly; Byamugisha, Josaphat K.; Tumwesigye, Nazarius Mbona; Almroth, Lars; Faxelid , Elisabeth
    Globally, 2–3 million women are estimated to have a genital fistula, with an annual incidence of 50,000–100,000 women. Affected women remain silent within their communities, and their experiences often go unnoticed. Our objective was to explore the experiences of Ugandan women living with genital fistulas to understand how their lives were affected and how they coped with the condition. We conducted 8 focus group discussions (FGDs) with 56 purposively selected women with a genital fistula seeking treatment at Mulago Hospital, Uganda. Data were transcribed and analysed using qualitative content analysis. Women with a fistula were living a physically changed and challenging life, living socially deprived and isolated, living psychologically stigmatised and depressed, and living marital and sexual lives that were no longer joyful. The women’s experiences were full of life changes and coping strategies, and they used both problem- and emotion-focused coping strategies to deal with the challenges. They devised ways to reduce the smell of urine to reduce the stigma, rejection and isolation. While trying to cope, the women found themselves alone and isolated. Women either isolated themselves or were isolated by society, including by close relatives and their husbands. Their sex lives were no longer enjoyable, and generally, women felt a loss of their marital and sexual rights. Women with a fistula make adjustments in their lives to cope with the physical, social, psychological and sexual challenges. They use both problem- and emotion-focused coping to minimise their sense of isolation, as well as the rejection and stigma associated with fistula. These findings are essential for counselling patients, families and community members affected by a fistula. In similar contexts, health programmes should go beyond fistula closure and target communities and families to reduce the stigma and isolation faced by women with genital fistula. Background A fistula is an abnormal opening between a woman’
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    Predictors of Post-Caesarean Surgical Site Infections at Mubende Regional Referral Hospital, Central Uganda: Prospective Cohort Study (July–September 2023)
    (International Journal of Women's Health, 2024-11-17) Omara, Samuel; Kasujja, Musa; Okot, Geoffrey; Barageine, Justus Kafunjo
    Post-caesarean surgical site infections (PCSSIs) significantly impact maternal morbidity, mortality, and healthcare costs in low- and middle-income countries, particularly in sub-Saharan Africa, where preventive measures are often inadequate. Despite this burden, data on PCSSIs in this context are limited. This study aimed to evaluate the incidence and factors associated with PCSSIs at Mubende Regional Referral Hospital.
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    Reintegration Needs of Young Women following Genitourinary Fistula Surgery in Uganda
    (Int Urogynecol J, 2019-02-27) Emasu, Alice; Matovu, Alphonsus; Alia, Godfrey; Barageine, Justus Kafunjo
    Genitourinary fistulas (usually arising following prolonged obstructed labor) are particularly devastating for women in low-income counties. Surgical repair is often difficult and delayed. While much attention has been devoted to technical surgical issues, the challenges of returning to normal personal, family, and community life after surgical treatment have received less scrutiny from researchers. We surveyed young Ugandan women recovering from genitourinary fistula surgery to assess their social reintegration needs following surgery.
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    Risk Factors for Neonatal Mortality in Rural Iganga District, Eastern Uganda: A Case Control Study
    (The East African Health Research Journal, 2023-11-30) Ndyomugyenyi, Bruce Donald; Nabukeera, Betty; Natukwatsa, Davis; Barageine, Justus Kafunjo; Kajungu, Dan
    Reducing Neonatal Mortality (NM) is vital in decreasing mortality in children below 5 years. Uganda has reported a significant reduction in under 5 and infant mortality over the past decade while NM has stagnated at 27 deaths per 1,000 live births. The NMR of 34 deaths per 1,000 live births in Eastern Uganda is higher than the national rate. To determine risk factors for neonatal mortality in rural Iganga district, Eastern Uganda. A matched case-control study was conducted between February and July 2019 in Nakigo and Nakalama sub-counties of Iganga district. Cases (n=91) were neonates that died and the controls (n=182) were live neonates at 1 month. Data on maternal, social demographic and neonatal variables were collected from mothers of neonates at household level. Descriptive analysis was performed to determine the profile of study participants. Data was presented as mean (and standard deviation) for continuous variables, and frequencies with percentages for categorical variables. A conditional logistic regression was performed to calculate Odds Ratios and to establish factors that were independently associated with risk of neonatal Mortality. Giving birth to 5 or more children (AOR=2.88, 95% CI =1.25–6.63), attending less than 4 antenatal care visits (AOR= 2.27, 95% CI= 1.14–5.54), and giving birth to twins (AOR= 6.30, 95% CI=1.24–32.0) were the risk factors for neonatal mortality while delivering from health facilities was protective (AOR= 0.26, 95% CI= 0.12–0.56). The risk factors for NM are: - giving birth to 5 or more children, attendance of less than 4 antenatal care visits and giving birth to twins. To reduce the risk of NM, the study re-emphasises the need to put more focus on neonatal care during pregnancy and child birth. The study findings can be utilised to determine priorities for reducing the risk of NM in rural settings.
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    Risk Factors for Obstetric Fistula in Western Uganda: A Case Control Study
    (PLoS One, 2014-11-17) Barageine, Justus Kafunjo; Tumwesigye, Nazarius Mbona; Byamugisha, Josaphat K.; Almroth, Lars; Faxelid, Elisabeth
    Two million women worldwide are living with genital fistula with an annual incidence of 50,000–100,000 women. Risk factors for obstetric fistula are context bound. Studies from other countries show variation in the risk factors for obstetric fistula. This study was conducted to identify risk factors for obstetric fistula in western Ugandan context. A case control study comparing background factors of women with obstetric fistula (cases) and women without fistula (controls) was conducted in western Uganda. Data was collected using face-to-face interviews. Univariate, bivariate and multivariate analysis was conducted using Stata 12. Altogether, 420 respondents (140 cases and 280 controls) participated in the study. Duration of labour was used to form the product terms when assessing for interaction and confounding since it was one the most significant factors at bivariate level with a narrow confidence interval and was hence considered the main predictor. After adjusting for interaction and confounding, significant risk factors associated with development of obstetric fistula in western Uganda were: Caesarean section (adjusted odds ratio [AOR]  = 13.30, 95% CI  = 6.74–26.39), respondent height of 150 cm or less (AOR  = 2.63, 95% CI  = 1.35–5.26), baby weight of 3.5 kg or more (AOR  = 1.52, 95% CI  = 1.15–1.99), prolonged labour (AOR  = 1.06, 95% CI  = 1.04–1.08. A quarter of the fistulas had resulted from iatrogenic complication during caesarean section. Compared to no education, post primary level of education was protective against obstetric fistula (AOR  = 0.31, 95% CI  = 0.13–0.72) and there was no difference between respondents without education and those with primary level education. Surgeons contribute to a big proportion (25%) of fistula cases hence caesarean section being a risk factor in this region. Other risk factors include; prolonged labour, weight of the baby of 3.5 kg or more, respondent height of 150 cm or less (short stature), and low or no education are risk factors for obstetric fistula in western Ugandan.