NRU :: Browsing by Author "Faxelid, Elisabeth"

Browsing by Author "Faxelid, Elisabeth"

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Adolescent and adult first time mothers' health seeking practices during pregnancy and early motherhood in Wakiso district, central Uganda
(Reproductive health, 2008) Atuyambe, Lynn; Mirembe, Florence; M. Tumwesigye, Nazarius; Annika, Johansson; Kirumira, Edward K.; Faxelid, Elisabeth
Maternal health services have a potentially critical role in the improvement of reproductive health. In order to get a better understanding of adolescent mothers 'needs we compared health seeking practices of first time adolescent and adult mothers during pregnancy and early motherhood in Wakiso district, Uganda. Methods: This was a cross-sectional study conducted between May and August, 2007 in Wakiso district. A total of 762 women (442 adolescents and 320 adult) were interviewed using a structured questionnaire. We calculated odds ratios with their 95% CI for antenatal and postnatal health care seeking, stigmatization and violence experienced from parents comparing adolescents to adult first time mothers. STATA V.8 was used for data analysis.
Constraints and prospects for contraceptive service provision to young people in Uganda: providers’ perspectives
(BMC Health Services Research, 2011) Nalwadda, Gorrette; Mirembe, Florence; Tumwesigye, Nazarius M.; Byamugisha, Josaphat; Faxelid, Elisabeth
Unintended pregnancies lead to unsafe abortions, which are a leading cause of preventable maternal mortality among young women in Uganda. There is a discrepancy between the desire to prevent pregnancy and actual contraceptive use. Health care providers’ perspectives on factors influencing contraceptive use and service provision to young people aged 15-24 in two rural districts in Uganda were explored. Semi-structured questionnaires were used for face- to-face interviews with 102 providers of contraceptive service at public, private not-for-profit, and private for-profit health facilities in two rural districts in Uganda. Descriptive and inferential statistics were used in the analysis of data.
Emergency Contraception and Fertility awareness among University Students in Kampala, Uganda
(African health sciences, 2006) Byamugisha, Josaphat K.; Mirembe, Florence M.; Faxelid, Elisabeth; Gemzell-Danielsson, Kristina
Uganda has a high maternal mortality ratio with unsafe abortions being one of the major causes. Young people are particularly vulnerable to unsafe induced abortion with its sequelae. Emergency contraception (EC) may reduce unsafe abortions if easily accessible and acceptable. To determine knowledge about, ever use and attitudes towards EC among resident and non-resident female first year university students in Kampala. This Cross sectional study was carried out at Makerere University from January to March 2005.Out of 5971 females admitted in the academic year 2004/2005,379 answered a self administered questionnaire. The students were approached individually and given the questionnaire if they consented. Results: The mean age of the participants was 21 years. Less than half (45.1%) had ever heard about emergency contraceptive pills (ECPs).The most common sources of information about EC were friends (34%),media (24.8%) and schools (19.4%) .The ever pregnancy rate was 3.4 percent and 42 percent were in a steady relationship of three or more months. The contraceptive ever-use rate was 14.5 percent. Among the users the most common methods were condoms (48.9%) and withdrawal (23.4%). Emergency contraceptive pills had been used by seven students. Forty two percent did not know the time interval within which ECPs can work and one third thought it would interrupt an ongoing pregnancy. Thirty five percent did not know when in the menstrual cycle they were likely to conceive. The majority of the students were against over the counter (OTC) availability of EC because of fear of misuse. Knowledge about Emergency contraception and fertility awareness is low among the female first year university students. Friends and the media are an important source of EC information. Awareness and knowledge of EC should be increased.
Influences on uptake of reproductive health services in Nsangi community of Uganda and their implications for cervical cancer screening
(Reproductive Health, 2007) Mutyaba, Twaha; Faxelid, Elisabeth; Mirembe, Florence; Weiderpass, Elisabete
Cervical cancer is the most common female cancer in Uganda. Over 80% of women diagnosed or referred with cervical cancer in Mulago national referral and teaching hospital have advanced disease. Plans are underway for systematic screening programmes based on visual inspection, as Pap smear screening is not feasible for this low resource country. Effectiveness of population screening programmes requires high uptake and for cervical cancer, minimal loss to follow up. Uganda has poor indicators of reproductive health (RH) services uptake; 10% postnatal care attendance, 23% contraceptive prevalence, and 38% skilled attendance at delivery. For antenatal attendance, attendance to one visit is 90%, but less than 50% for completion of care, i.e. three or more visits.
Knowledge, attitudes and prescribing pattern of emergency contraceptives by health care workers in Kampala, Uganda
(Acta obstetricia et gynecologica Scandinavica, 2007) Byamugisha, Josaphat K.; Mirembe, Florence M.; Faxelid, Elisabeth; Gemzell-Danielsson, Kristina
Health care workers (HCWs) play an important role in making emergency contraceptives (ECs) available to clients. They can influence accessibility positively through counselling, prescribing or advocating the use of ECs. However, in some settings, HCWs have been blamed for unfavourable attitudes and lack of accurate information. Objective . To assess the knowledge, attitudes and prescribing pattern of EC by HCWs in Kampala district, Uganda. Methods. The total number of health units at different levels of health care delivery in Kampala (894) was obtained. Probability proportional to size (PPS) technique of sampling was applied. Some 247 HCWs completed a selfadministered questionnaire on their knowledge about EC, including methods, mechanism of action, prescription of EC, sources of information, attitudes towards EC, and if and how it should be made available. Results . Of the HCWs, 80% had knowledge of ECs. However, 1 in every 4 was not sure about the time limit within which EC is effective. A total of 50% of the participants had obtained information from a physician (26.4%) or from a training school (24%). The Yuzpe regimen was the most commonly mentioned and prescribed method of EC. The HCWs attitudes to EC were generally positive, and it was suggested that the community should be informed and sensitised about EC. There was a significant difference between having had a family planning educational update or not in the last year and knowledge of EC (p 0.005). Conclusion . Most HCWs were aware of EC, but some lacked important knowledge on its use or available methods. Recommendation. HCWs should have regular (annual) in-service training in reproductive health issues, such as counselling on EC. This will enable them to keep up to date with the current evidence-based recommendations in the field of contraceptive technology.
Persistent high fertility in Uganda: young people recount obstacles and enabling factors to use of contraceptives
(BMC Public Health, 2020) Nalwadda, Gorrette; Mirembe, Florence; Byamugisha, Josaphat; Faxelid, Elisabeth
High fertility among young people aged 15-24 years is a public health concern in Uganda. Unwanted pregnancy, unsafe induced abortions and associated high morbidity and mortality among young women may be attributed to low contraceptive use. This study aims at exploring reasons for low contraceptive use among young people. Methods: In 16 focus group discussions, the views of young people about obstacles and enabling factors to contraceptive use in Mityana and Mubende districts, Uganda were explored. The groups were homogeneously composed by married and unmarried men and women, between the ages of 15-24. The data obtained was analyzed using qualitative content analysis
Quality of Care in Contraceptive Services Provided to Young People in Two Ugandan Districts: A Simulated Client Study
(PLoS ONE, 2011) Nalwadda, Gorrette; Tumwesigye, Nazarius M.; Faxelid, Elisabeth; Byamugisha, Josaphat; Mirembe, Florence
Low and inconsistent use of contraceptives by young people contributes to unintended pregnancies. This study assessed quality of contraceptive services for young people aged 15–24 in two rural districts in Uganda. Five female and two male simulated clients (SCs) interacted with 128 providers at public, private not-for-profit (PNFP), and private for profit (PFP) health facilities. After consultations, SCs were interviewed using a structured questionnaire. Six aspects of quality of care (client’s needs, choice of contraceptive methods, information given to users, client-provider interpersonal relations, constellation of services, and continuity mechanisms) were assessed. Descriptive statistics and factor analysis were performed. Means and categorized quality scores for all aspects of quality were low in both public and private facilities. The lowest quality scores were observed in PFP, and medium scores in PNFP facilities. The choice of contraceptive methods and interpersonal relations quality scores were slightly higher in public facilities. Needs assessment scores were highest in PNFP facilities. All facilities were classified as having low scores for appropriate constellation of services. Information given to users was suboptimal and providers promoted specific contraceptive methods. Minority of providers offered preferred method of choice and showed respect for privacy. The quality of contraceptive services provided to young people was low. Concurrent quality improvements and strengthening of health systems are needed.
A randomized clinical trial of two emergency contraceptive pill regimens in a Ugandan population
(Acta Obstetricia et Gynecologica, 2010) Byamugisha, Josaphat K.; Mirembe, Florence M.; Faxelid, Elisabeth; Tumwesigye, Nazarius M.; Gemzell-Danielsson, Kristina
Recent trials on emergency contraception (EC) have indicated that levonorgestrel (LNG) used alone has fewer side-effects and is more efficacious than the Yuzpe regimen (high dose combined oral contraceptive pills). However, the experienced side-effects and acceptability may vary between different groups or societies. Objective. The primary objective of this study was to determine side-effects and acceptability of two emergency contraceptive pill (ECP) regimens among users in Kampala, Uganda. Study design. Randomized clinical trial. Methods. A total of 337 women were enrolled in a double blind randomized clinical trial. Women requesting ECPs within 72 hours after unprotected sexual intercourse received either LNG or the Yuzpe regimen. The women returned for follow-up after three days and a follow-up interview was performed after one year. Results. Levonorgestrel had significantly fewer side-effects than the Yuzpe regimen (p < 0.001). There was a significant association between having worries about the method and experiencing side-effects (p < 0.001). Most women (81%) were prime users of EC. The majority would recommend ECP to other clients. Conclusions. Levonorgestrel is a superior option to the Yuzpe regimen and should be promoted as the recommended ECP. Having worries about ECP may influence experience of the side-effects. Correct information is critical in promotion of ECP use.
Young peoples’ interface with providers of contraceptive care: a simulated client study in two Ugandan districts
(Contraception and Reproductive Medicine, 2016) Nalwadda, Gorrette; Mirembe, Florence; Byamugisha, Josaphat; Tumwesigye, Nazarius M.; Faxelid, Elisabeth
Young people in Uganda have a large unmet need for modern contraception, and the reasons are unclear. This study describes young peoples’ experiences of contraceptive care, client-provider interactions and its aftermath on choice, access and satisfaction. Simulated client method, with 128 encounters with providers in public and private health care facilities was used. Semi-structured narrative debriefing and a structured questionnaire were used to collect data. Content analysis, descriptive and inferential statistics were applied.

Browsing by Author "Faxelid, Elisabeth"

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