Browsing by Author "Diallo, Abdoulaye Hama"

Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    “If I have money, I cannot allow my baby to breastfeed only …” barriers and facilitators to scale-up of peer counselling for exclusive breastfeeding in Uganda
    (International Breastfeeding Journal, 2020) Rujumba, Joseph; Ndeezi, Grace; Nankabirwa, Victoria; Kwagala, Mary; Mukochi, Michelle; Diallo, Abdoulaye Hama; Meda, Nicolas; Engebretsen, Ingunn M. S.; Tylleskär, Thorkild; Tumwine, James
    Early initiation and exclusive breastfeeding for 6 months reduces infant morbidity and mortality and can positively impact on cognitive function. In Uganda, exclusive breastfeeding for 6 months is recommended but many women introduce alternative feeds early. Interventions to scale-up peer support provision for exclusive breastfeeding are limited. We explored the barriers, facilitators and solutions to scaling-up of peer counselling support for exclusive breastfeeding in Uganda.A qualitative study was conducted in Mbale District and Kampala City between April and July 2014. Data were collected through 15 key informant interviews with health workers and managers of organizations involved in child and maternal health as well as seven focus group discussions with peer counsellors who took part in the PROMISE EBF Trial (2006–2008), VHT members, mothers and fathers of children aged 1 year and below. Data were analysed using the content thematic approach.The need for peer support for exclusive breastfeeding, especially for young and first-time mothers, was highlighted by most study participants. While mothers, mothers-in-law, friends and husbands were mentioned as major stakeholders regarding infant feeding, they were perceived to lack adequate information on breastfeeding. Health workers were mentioned as a key source of support, but their constraints of heavy workloads and lack of education materials on breastfeeding were highlighted. High community expectations of peer counsellors, the perceived inadequacy of breast milk, general acceptability of complimentary feeding, household food insecurity, heavy workload for women and unsupportive ‘work-places’ were key barriers to scaling-up of peer counselling support for breastfeeding. The peer counsellors who were part of the PROMISE EBF trial in Mbale, the village health team programme, health facilities, community groups, the media and professional associations emerged as potential facilitators that can aid the scaling-up of peer counselling support for breastfeeding.Peer support for breastfeeding is highly valued in this setting. The health system and health workers are regarded as the main facilitators to scaling-up of peer support for exclusive breastfeeding. Partnerships with village health teams (VHTs), community groups, role models, professional associations and the media are other potential facilitators to this scaling-up.
  • Thumbnail Image
    Item
    Prevalence and correlates of paediatric guideline non-adherence for initial empirical care in six low and middle-income settings: a hospital-based cross-sectional study
    (British Medical Journal Publishing Group, 2024-03) Shawon, Riffat Ara; Denno, Donna; Tickell, Kirkby D; Atuhairwe, Michael; Bandsma, Robert; Mupere, Ezekiel; Voskuijl, Wieger; Mbale, Emmie; Ahmed, Tahmeed; Chisti, Md Jobayer; Saleem, Ali Faisal; Ngari, Moses; Diallo, Abdoulaye Hama; Berkley, James; Walson, Judd; Means, Arianna Rubin
    Objectives This study evaluated the prevalence and correlates of guideline non-adherence for common childhood illnesses in low-resource settings.Design and setting We used secondary cross-sectional data from eight healthcare facilities in six Asian and African countries.Participants A total of 2796 children aged 2–23 months hospitalised between November 2016 and January 2019 with pneumonia, diarrhoea or severe malnutrition (SM) and without HIV infection were included in this study.Primary outcome measures We identified children treated with full, partial or non-adherent initial inpatient care according to site-specific standard-of-care guidelines for pneumonia, diarrhoea and SM within the first 24 hours of admission. Correlates of guideline non-adherence were identified using generalised estimating equations.Results Fully adherent care was delivered to 32% of children admitted with diarrhoea, 34% of children with pneumonia and 28% of children with SM when a strict definition of adherence was applied. Non-adherence to recommendations was most common for oxygen and antibiotics for pneumonia; fluid, zinc and antibiotics for diarrhoea; and vitamin A and zinc for SM. Non-adherence varied by site. Pneumonia guideline non-adherence was more likely among patients with severe disease (OR 1.82; 95% CI 1.38, 2.34) compared with non-severe disease. Diarrhoea guideline non-adherence was more likely among lower asset quintile groups (OR 1.16; 95% CI 1.01, 1.35), older children (OR 1.10; 95% CI 1.06, 1.13) and children presenting with wasting (OR 6.44; 95% CI 4.33, 9.57) compared with those with higher assets, younger age and not wasted. Conclusions Non-adherence to paediatric guidelines was common and associated with older age, disease severity, and comorbidities, and lower household economic status. These findings highlight opportunities to improve guidelines by adding clarity to specific recommendations.