NRU :: Browsing by Author "Kabagenyi, Allen"

Browsing by Author "Kabagenyi, Allen"

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Adherence to COVID-19 preventive measures and its association with intimate partner violence among women in informal settings of Kampala, Uganda
(PLOS Global Public Health, 2022) Anguzu, Ronald; Kabagenyi, Allen; Cassidy, Laura D.; Kasasa, Simon; Shour, Abdul R.; Musoke, Bernadette N.; Mutyoba, Joan N.
Cases of coronavirus disease 2019 (COVID-19) detected, and COVID-19 associated mortality increased since the first case was confirmed in Uganda. While adherence to WHO-recommended measures to disrupt COVID-19 transmission has since been implemented, it has been reported to be sub-optimal. An increase in intimate partner violence (IPV) cases was linked to enforcement of COVID-19 lockdowns and other preventive measures especially in informal settings of Kampala. We determined the association between adherence to COVID-19 preventive measures and intimate partner violence among women dwelling in informal settings in Kampala, Uganda. Between July and October 2020, we conducted a three-month prospective cohort study of 148 women living in informal settlements of Kampala during the COVID-19 lockdown and easing of restrictive measures. Participants were surveyed at baseline, at 3-weeks and 6-weeks (endline). The dependent variable was adherence to COVID-19 preventive measures (remained adherent vs poorly adherent) between baseline and endline surveys. This composite outcome variable was computed from implementing all four variables: social distancing, wearing face masks, frequent hand washing and use of hand sanitizers at baseline and endline surveys. The key independent variable was IPV measured as experiencing at least one form of physical, emotional, or sexual IPV. Covariates were age, education, marital status, household size, occupation, and having problems getting food. Adjusted logistic regression analyses tested the independent association between adherence to COVID-19 preventive measures and intimate partner violence. Among 148 respondents, the mean age (SD) was 32.9 (9.3) years, 58.1% were exposed to at least one form of IPV, and 78.2% had problems getting food. Overall, 10.1% were poorly adherent to COVID-19 preventive measures during the first COVID-19 wave. After controlling for potential confounders, remaining adherent to COVID-19 preventive measures were more likely to experience intimate partner violence when compared to women who were poorly adherent to COVID-19 preventive measures during the first COVID-19 wave in Uganda [OR 3.87 95%CI (1.09, 13.79)]. Proportions of women in informal settlements of Kampala experiencing at least one form of IPV during the first COVID-19 wave is substantial. Remaining adherent to preventive measures for COVID-19 transmission may increase IPV exposure risk among women living in informal settlements in Kampala. Contextualizing COVID-19 interventions to the needs of marginalized and vulnerable women and girls in informal settings of Kampala is warranted. Processes to integrated violence prevention and response strategies into the Uganda COVID-19 prevention strategy are underscored.
Age at first marriage, age at first sex, family size preferences, contraception and change in fertility among women in Uganda: analysis of the 2006–2016 period
(BMC women's health, 2020) Ariho, Paulino; Kabagenyi, Allen
Uganda’s fertility was almost unchanging until the year 2006 when some reductions became visible. Compared to age at first marriage and contraceptive use, age at sexual debut and family size preferences are rarely examined in studies of fertility decline. In this study, we analyzed the contribution of age at first marriage, age at first sex, family size preferences and contraceptive use to change in fertility in Uganda between 2006 and 2016. Methods: Using data from the 2006 and 2016 Uganda Demographic and Health Survey (UDHS), we applied a nonlinear multivariate decomposition technique to quantify the contribution of age at first marriage, age at first sex, family size preference and contraceptive use to the change in fertility observed during the 2006–2016 period. Results: The findings indicate that 37 and 63% of the change in fertility observed between 2006 and 2016 was respectively associated with changing characteristics and changing fertility behavior of the women. Changes in proportion of women by; age at first marriage, age at first sex, family size preferences and contraceptive use were respectively associated with 20.6, 10.5 and 8.4% and 8.2% of the change in fertility but only fertility behavior resulting from age at first sex was significantly related to the change in fertility with a contribution of 43.5%. Conclusions: The study quantified the contribution of age at first marriage, age at first sex, family size preferences and contraceptive use to the change in fertility observed between 2006 and 2016. We highlight that of the four factors, only age at sexual debut made a significant contribution on the two components of the decomposition. There is need to address the low age at first sex, accessibility, demand for family planning services and youth-friendly family planning services to young unmarried women such that they can achieve their desired fertility. The contribution of other factors such as education attainment by women and place of residence and their relationship with changes in fertility calls for addressing if further reduction in fertility is to be realised.
Analysis of the Prevalence of the Preferred Methods of Contraception During the COVID 19 Lockdown in Uganda: A Multinomial Logistic Regression Study
(A Multinomial Logistic Regression Study, 2021) Sseninde, Julius; Kabagenyi, Allen; Kyadondo, Betty; Nyachwo, Evelyne; Kiragga, Agnes; Wasswa, Ronald
In 2020 limitations to family planning information, access and utilization were exacerbated by the COVID-19 pandemic and lockdown, globally incapacitating various channels to family planning information, access and, utilization. This study sought to analyze the prevalence of the preferred methods of contraception during the COVID 19 lockdown in Uganda using multinomial logistic regression. Method Data were analyzed using univariate, bivariate, logistic, and multinomial logistic regression models from the post-intervention telehealth cross-sectional survey. Results Out of the 244 women surveyed, more than three quarters (80%) used their preferred methods of family planning, while almost half of the participants (46%) used the Short-Acting Methods as a preferred method of Family planning. The logistic regression showed that older-aged participants, fear of security personnel, and fear that my spouse will know that the partner is using family planning as their biggest challenge plus participants who agreed that they won’t continue using family planning after the lockdown were less likely to use the preferred method of family planning. However, participants whose biggest challenge to accessing family planning information, and utilization was lack of money, those who received an extremely adequate number of messages during the intervention, and those who were already using family planning before the intervention were more likely to use their preferred method of family planning. From the multinomial model, participants whose biggest challenges in accessing family planning services during the lockdown were fear of unwanted pregnancy, and fear if implant expires in her body were relatively more likely to use Long-term Acting Reversible Contraceptives than Short-Acting Contraceptives as their preferred method of Family Planning. While participants who were relatively less likely to use LARC compared to SAC were those already using family planning before the start of the intervention. Conclusions We recommend prioritizing family planning information, access and utilization as one of the essential services during the lockdown, with more emphasis on an intervention that addresses age-specific needs and partner privacy issues. Addressing the use of LARC among women who are already using contraceptives is equally paramount in cases of lockdown and health facility closures
Barriers to male involvement in contraceptive uptake and reproductive health services: a qualitative study of men and women’s perceptions in two rural districts in Uganda
(Reproductive health, 2014) Kabagenyi, Allen; Jennings, Larissa; Reid, Alice; Nalwadda, Gorette; Ntozi, James; Atuyambe, Lynn
Spousal communication can improve family planning use and continuation. Yet, in countries with high fertility rates and unmet need, men have often been regarded as unsupportive of their partner’s use of family planning methods. This study examines men and women’s perceptions regarding obstacles to men’s support and uptake of modern contraceptives. Methods: A qualitative study using 18 focus group discussions (FGDs) with purposively selected men aged 15–54 and women aged 15–49 as well as eight key informant interviews (KIIs) with government and community leaders was conducted in 2012 in Bugiri and Mpigi Districts, Uganda. Open-ended question guides were used to explore men and women’s perceptions regarding barriers to men’s involvement in reproductive health. All FGDs and KIIs were recorded, translated, and transcribed verbatim. Transcripts were coded and analyzed thematically using ATLAS.ti. Results: Five themes were identified as rationale for men’s limited involvement: (i) perceived side effects of female contraceptive methods which disrupt sexual activity, (ii) limited choices of available male contraceptives, including fear and concerns relating to vasectomy, (iii) perceptions that reproductive health was a woman’s domain due to gender norms and traditional family planning communication geared towards women, (iv) preference for large family sizes which are uninhibited by prolonged birth spacing; and (v) concerns that women’s use of contraceptives will lead to extramarital sexual relations. In general, knowledge of effective contraceptive methods was high. However, lack of time and overall limited awareness regarding the specific role of men in reproductive health was also thought to deter men’s meaningful involvement in issues related to fertility regulation. Conclusion: Decision-making on contraceptive use is the shared responsibility of men and women. Effective development and implementation of male-involvement family planning initiatives should address barriers to men’s supportive participation in reproductive health, including addressing men's negative beliefs regarding contraceptive services.
Correlates of uptake of optimal doses of sulfadoxine‑pyrimethamine for prevention of malaria during pregnancy in East‑Central Uganda
(Malaria Journal, 2020) Mbonye, K. Martin; Kirwana, B. Venantius; Ndugga, Patricia; Kikaire, Bernard; Baleeta, Keith; Kabagenyi, Allen; Asiimwe, Godfrey; Twesigye, Rogers; Kadengye T., Damazo; Dathan, Byonanebye M.
In 2012, the World Health Organization recommended that pregnant women in malaria-endemic countries complete at least three (optimal) doses of intermittent preventive treatment (IPTp) using sulfadoxinepyrimethamine (SP) to prevent malaria and related adverse events during pregnancy. Uganda adopted this recommendation, but uptake remains low in East-Central and information to explain this low uptake remains scanty. This analysis determined correlates of uptake of optimal doses of IPTp-SP in East-Central Uganda. Methods: This was a secondary analysis of the 2016 Uganda Demographic Health Survey data on 579 women (15–49 years) who attended at least one antenatal care (ANC) visit and had a live birth within 2 years preceding the survey. Uptake of IPTp-SP was defined as optimal if a woman received at least three doses; partial if they received 1–2 doses or none if they received no dose. Multivariate analysis using multinomial logistic regression was used to determine correlates of IPTp-SP uptake. Results: Overall, 22.3% of women received optimal doses of IPTp-SP, 48.2% partial and 29.5% none. Attending ANC at a lower-level health centre relative to a hospital was associated with reduced likelihood of receiving optimal doses of IPTp-SP. Belonging to other religious faiths relative to Catholic, belonging to a household in the middle relative to poorest wealth index, and age 30 and above years relative to 25–29 years were associated with higher likelihood of receiving optimal doses of IPTp-SP. Conclusions: In East-Central Uganda, uptake of optimal doses of IPTp-SP is very low. Improving institutional delivery and household wealth, involving religious leaders in programmes to improve uptake of IPTp-SP, and strengthening IPTp-SP activities at lower level health centers may improve uptake of IPTp-SP in the East-Central Uganda.
Demand for Family Planning among Poor Women in Uganda: Analysis of the Uganda Demographic and Health Surveys
(Research Square, 2020) Kabagenyi, Allen; Kakande, Pamela; Owayezu, Vianney
Family planning is one of the major cost-effective interventions to improve maternal health, reduce maternal and child mortality, and prevent unplanned pregnancies, yet its use remains low in sub- Saharan Africa, especially among the poor. In Uganda, little is known about the factors influencing the demand for family planning among the poor. This study examines the determinants of demand for family planning among poor women in a low income country. Methods: The study is based on data from the 2006, 2011, and 2016 Uganda Demographic and Health Surveys (UDHS). The analysis was carried using weighted samples of 2,238 in 2006, 2,164 in 2011, and 4,370 in 2016. Descriptive statistics, and binary logistic regressions presenting both the unadjusted and adjusted were used to examine the influence of different demographic, behavioral, and socioeconomic factors on poor women’s demand for family planning. Results: Our findings showed demand for family planning was 56% in 2006, 60% in 2011, and 65% in 2016 among women in the poorest and poorer household health quintiles who were married or in union. In all three surveys, women age 25-39 had higher odds of demand for family planning compared with women age 15-24 (AOR=1.5, 95% CI=1.1-1.9 in 2006, AOR=2.2, 95% CI=1.7-2.7 in 2011, AOR=1.7, 95% CI=1.5-2.0 in 2016). Women with no education had lower odds of demand for family planning compared with those with secondary education (AOR=0.4, 95% CI=0.3-0.6, pooled results). Also, in the 2011 UDHS, women who had heard about family planning on the radio had higher odds of demand (AOR=1.4, 95% CI=1.1-1.7, pooled) for family planning compared with those who had not, and in the 2006 survey women who had discussed family planning at a health facility had higher odds of demand for family planning (AOR=1.0, 95% CI=0.8-1.2) compared with women who had not done so. Conclusions: Demand for family planning is influenced by a woman’s age, educational attainment, religion, exposure to family planning messages on the radio, and discussion on family planning at a health facility. This study underscores the need for increased family planning counseling by health workers and more discussion about family planning at the health facility. The findings further suggest the need to provide increased adequate family planning services and information for the poor, uneducated, and rural women to meet the demand for family planning.
Determinants of change in fertility pattern among women in Uganda during the period 2006–2011
(Fertility Research and Practice, 2018) Ariho, Paulino; Kabagenyi, Allen; Nzabona, Abel
Studies on fertility in Uganda have attributed fertility reduction to a shift in the overall characteristics of women of reproductive age. It is not clear whether the reduction in fertility is due to changing socioeconomic and demographic characteristics over time or stems from the shifts in the reproductive behavior of women. In this paper we examine how fertility rates have changed between 2006 and 2011 and whether these changes have resulted from changing characteristics or from changing reproductive behavior of women. Methods: Using the 2006 and 2011 Demographic and Health Survey data for Uganda, Multivariate Poisson Decomposition techniques were applied to evaluate observed changes in fertility. Results: Changing characteristics of women aged 15–49 years significantly contributed to the overall change in fertility from 2006 to 2011. The change observed in older age at first marriage was the major contributor to the changes in fertility. The contribution that can be attributed to changes in reproductive behavior was not significant. Conclusions: This study finds that the major contribution to the reduction in fertility between 2006 and 2011 was from increased education and delayed marriage among women. Continued improvement in secondary school completion, will lead to older age at first marriage and will continue to be an important factor in Uganda’s declining fertility rates.
Determinants of change in the inequality and associated predictors of teenage pregnancy in Uganda for the period 2006– 2016: analysis of the Uganda Demographic and Health Surveys
(BMJ Open, 2021) Wasswa, Ronald; Kabagenyi, Allen; Muhumuza Kananura, Rornald; Jehopio, Joseph; Rutaremwa, Gideon
Teenage pregnancy has become a public health concern in Uganda because of its negative consequences to both the mother and child. The objective of this study was to examine the determinants of change in the inequality and associated predictors of teenage pregnancy in Uganda for the period 2006– 2016. Study design A retrospective national cross-sectional study. Setting Uganda. Participants Uganda Demographic and Health Survey secondary data of only female teenagers aged 15–19 years. The samples selected for analyses were 1936 in 2006; 2048 in 2011 and 4264 in 2016. Outcome measure The primary outcome was teenage pregnancy. Analysis was performed using the logistic regression, equiplots, concentration curve, normalised concentration index, decomposition of the concentration index and Oaxaca-type decomposition. Results The prevalence of teenage pregnancy has seemingly remained high and almost constant from 2006 to 2016 with the risk worsening to the disadvantage of the poor. Household wealth-index, teenagers’ years of education, early sexual debut and child marriage were the main key predictors and contributors of the large inequality in teenage pregnancy from 2006 to 2016. Conclusion Teenage pregnancy is disproportionately prevalent among different subpopulations of adolescent girls in Uganda. We therefore recommend policy actions to sensitise communities and enforcement of child rights and child protection laws to stop child marriages. There is also need to promote girl child education, improving household incomes, and intensifying mass media awareness on the risks of early pregnancies. Further, ensuring that villages have operational adolescent and youth friendly services as well as incorporating sex education and other different adolescent reproductive health programmes in school curriculum will be key measures in reducing the large inequality in teenage pregnancy.
Determinants of change in the inequality and associated predictors of teenage pregnancy in Uganda for the period 2006– 2016: analysis of the Uganda Demographic and Health Surveys
(British Medical Journal Publishing Group, 2021-11) Wasswa, Ronald; Kabagenyi, Allen; Kananura, Rornald Muhumuza; Jehopio, Joseph; Rutaremwa, Gideon
Objective Teenage pregnancy has become a public health concern in Uganda because of its negative consequences to both the mother and child. The objective of this study was to examine the determinants of change in the inequality and associated predictors of teenage pregnancy in Uganda for the period 2006–2016.Study design A retrospective national cross-sectional study.Setting Uganda.Participants Uganda Demographic and Health Survey secondary data of only female teenagers aged 15–19 years. The samples selected for analyses were 1936 in 2006; 2048 in 2011 and 4264 in 2016.Outcome measure The primary outcome was teenage pregnancy. Analysis was performed using the logistic regression, equiplots, concentration curve, normalised concentration index, decomposition of the concentration index and Oaxaca-type decomposition.Results The prevalence of teenage pregnancy has seemingly remained high and almost constant from 2006 to 2016 with the risk worsening to the disadvantage of the poor. Household wealth-index, teenagers’ years of education, early sexual debut and child marriage were the main key predictors and contributors of the large inequality in teenage pregnancy from 2006 to 2016.Conclusion Teenage pregnancy is disproportionately prevalent among different subpopulations of adolescent girls in Uganda. We therefore recommend policy actions to sensitise communities and enforcement of child rights and child protection laws to stop child marriages. There is also need to promote girl child education, improving household incomes, and intensifying mass media awareness on the risks of early pregnancies. Further, ensuring that villages have operational adolescent and youth friendly services as well as incorporating sex education and other different adolescent reproductive health programmes in school curriculum will be key measures in reducing the large inequality in teenage pregnancy.
Determinants of Fertility Change in the Period 2006-2011 among Women Aged 15-49 Years in Uganda
(PAA 2018 Annual Meeting, 2018) Ariho, Paulino; Kabagenyi, Allen; Nzabona, Abel
Studies on fertility in Uganda have highlighted the importance of demographic and socioeconomic factors in fertility change but have not isolated the portion of fertility change attributable to changing characteristics of women from that due to changing behavioral effects. Methods: Using DHS survey data for Uganda, we decomposed the 2006-2011 change in fertility among women aged 15-49 years into portions attributable to changing characteristics of women and changing behavioral effects. Results: The overall change in fertility was largely attributed to changing characteristics of women aged 15-49 years in the 2006-2011 period rather than changing behavioral effects. Change in education level attained and age at first marriage contributed the biggest percentage to change in fertility between 2006 and 2011. Other significant contributors were changes in; family size preference, women’s working status, contraceptive use, exposure to family planning messages, place of residence and age at first sex. Conclusion: This paper suggests that improvements in social, economic and demographic characteristics of Ugandan women are the key drivers of the reduction in fertility levels in Uganda. With continued improvement in secondary school completion, age at first marriage, contraceptive use and family size preferences will continue to be an important factor of Uganda’s fertility transition. It is imperative for government and other stakeholder to work out appropriate strategies to ensure that girls complete at least secondary level of education
Determinants of postnatal care service utilization among mothers of Mangochi district, Malawi: a community-based crosssectional study
(BMC pregnancy and childbirth, 2021) Sagawa, Jonas; Kabagenyi, Allen; Turyasingura, Godwin; Mwale, Saul Eric
Postnatal care (PNC) service is a neglected yet an essential service that can reduce maternal, neonatal and infant morbidity and mortality rates in low and middle-income countries. In Malawi, maternal and infant mortality rates remain high despite numerous efforts by the government and its partners to improve maternal health service coverage across the country. This study examined the determinants of PNC utilization among mothers in Mangochi District, Malawi. Methods: A community based cross-sectional study was conducted among 600 mothers who gave birth in the past 2 years preceding January 1–31; 2016. A multistage sampling technique was employed to select respondents from nine randomly selected villages in Mangochi district. A transcribed semi-structured questionnaire was pretested, modified and used to collect data on socio-demographic characteristics and maternal related factors. Data was coded in EpiData version 3.1 and analysed in Stata version 12. A multivariable logistic regression adjusted for confounding factors was used to identify predictors of PNC utilization using odds ratio with 95% confidence interval and p-value of 0.05. Results: The study revealed that the prevalence of PNC service utilization was 84.8%. Mother’s and partner’s secondary education level and above (AOR = 2.42, CI: 1.97–6.04; AOR = 1.45, CI: 1.25–2.49), partner’s occupation in civil service and business (AOR = 3.17, CI: 1.25, 8.01; AOR =3.39, CI:1.40–8.18), household income of at least MK50, 000 (AOR = 14.41, CI: 5.90–35.16), joint decision making (AOR = 2.27, CI: 1.13, 4.57), knowledge of the available PNC services (AOR = 4.06, CI: 2.22–7.41), knowledge of at least one postpartum danger sign (AOR = 4.00, CI: 2.09, 7.50), health facility delivery of last pregnancy (AOR = 6.88, CI: 3.35, 14.14) positively associated with PNC service utilization. Conclusion: The rate of PNC service utilization among mothers was 85%. The uptake of PNC services among mothers was mainly influenced by mother and partner education level, occupation status of the partner, household income, decision making power, knowledge of available PNC services, knowledge of at least one postpartum danger signs, and place of delivery. Therefore, PNC awareness campaigns, training and economic empowerment programs targeting mothers who delivered at home with primary education background and low economic status are needed.
Determinants of unintended pregnancies among currently married women in Uganda
(Journal of Health, Population and Nutrition, 2020) Wasswa, Ronald; Kabagenyi, Allen; Atuhaire, Leonard
Unintended pregnancies are no longer bound to teenagers or school-going children, married women in Uganda, as well do experience such pregnancies though little has been investigated on them. This study examines the determinants of unintended pregnancies among currently married women in Uganda. Methods: In this study, we used data from the 2016 Uganda Demographic and Health Survey (UDHS) which comprised of 10,958 married women aged 15–49 years who have ever been pregnant. The analysis was done using descriptive analysis, logistic regression, and the generalized structural equation model. Results: The study showed that 37% of pregnancies among married women were unintended. Young women, living in poor households, staying in rural areas, women in the Eastern and Northern region, Muslim women, lack of knowledge on ovulation period, discontinuation of contraceptives, non-use of and intention for contraceptives, high age at sexual debut, high age at first birth, and high parity were directly associated with a higher risk of unintended pregnancies. Relatedly, discontinuation of contraceptives regardless of the place of residence, region, woman’s age, education, household wealth, access to family planning messages were associated with higher odds of unintended pregnancies. Older women and those in rural areas who had more children were also at a higher risk of similar pregnancies. However, having more children while using contraceptives, being educated, living in a wealthier household, and having access to family planning messages significantly lowered the risk of unintended pregnancies. Conclusion: Increased access to family planning messages, empowering women as well as having improved household incomes are key preventive measures of unintended pregnancies. There is a need to provide quality contraceptive counseling through outreaches so that women are informed about the different contraceptive methods and the possible side effects. Having a variety of contraceptive methods to choose from and making them accessible and affordable will also encourage women to make informed choices and reduce contraceptive discontinuation. All these coupled together will help women have their desired family sizes, increase the uptake of contraceptives and significantly reduce unintended pregnancies.
Disruption in Essential Health Service Delivery: A Qualitative Study on Access to Family Planning Information and Service Utilization During the First Wave of COVID-19 Pandemic in Uganda
(Open Access Journal of Contraception, 2022) Kabagenyi, Allen; Kyaddondo, Betty; Baelvina Nyachwo, Evelyne; Wasswa, Ronald; Bwanika, John Mark; Kabajungu, Enid; Kiragga, Agnes
Coronavirus disease 2019 (COVID-19) remains a challenge to public health with profound impact on people’s lives. With several mitigation measures implemented to curb the spread of COVID-19, these impacted on access and utilization of general health services including family planning (FP) services. The objective of the study was to understand the extent to which COVID-19 interrupted access and utilization of FP services as well as highlight the challenges faced during the lockdown in Uganda. Methods: A qualitative study was carried out in August and September 2020 across the country. A total of 21 key informant interviews among researchers, policy makers, funding agencies, district family planning focal persons, district health officers and service providers with implementing partners were conducted. These were conducted using face to face (7), phone calls (11) and zoom (3) meetings. All interviews were audio recorded and transcribed verbatim. Transcripts were used to identify and generate codes, sub themes and themes. Analysis was done using the thematic framework analysis and results presented in themes. Results: Five themes were identified in this study which included; (i) financial and psychosocial needs, (ii) mobility hindrances, (iii) disrupted service delivery, (iv) responsive reproductive health services. The financial and psychosocial needs themes included: household and individual financial constraints, unpredictable future and community acceptance, loss of employment and unemployment, misconceptions and unintended pregnancies; while mobility hindrances included; restricted movement, high transport costs, and difficulty in finding transport. Conclusion: Results showed that the pandemic had immediate and significant long-term effects on family planning service accessibility, utilization and delivery. The study recommends implementation of telehealth services, country-wide sensitization on use of long-term contraceptive methods, empowering village health teams and making family planning services mandatory and free to all private facilities in order to lower any disruptions during pandemics.
Disruption in Essential Health Service Delivery: A Qualitative Study on Access to Family Planning Information and Service Utilization During the First Wave of COVID-19 Pandemic in Uganda
(Open Access Journal of Contraception, 2022) Kabagenyi, Allen; Kyaddondo, Betty; Nyachwo, Evelyne Baelvina; Wasswa, Ronald; Bwanika, John Mark; Kabajungu, Enid; Kiragga, Agnes
Background Coronavirus disease 2019 (COVID-19) remains a challenge to public health with profound impact on people’s lives. With several mitigation measures implemented to curb the spread of COVID-19, these impacted on access and utilization of general health services including family planning (FP) services. The objective of the study was to understand the extent to which COVID-19 interrupted access and utilization of FP services as well as highlight the challenges faced during the lockdown in Uganda. Methods A qualitative study was carried out in August and September 2020 across the country. A total of 21 key informant interviews among researchers, policy makers, funding agencies, district family planning focal persons, district health officers and service providers with implementing partners were conducted. These were conducted using face to face (7), phone calls (11) and zoom (3) meetings. All interviews were audio recorded and transcribed verbatim. Transcripts were used to identify and generate codes, sub themes and themes. Analysis was done using the thematic framework analysis and results presented in themes. Results Five themes were identified in this study which included; (i) financial and psychosocial needs, (ii) mobility hindrances, (iii) disrupted service delivery, (iv) responsive reproductive health services. The financial and psychosocial needs themes included: household and individual financial constraints, unpredictable future and community acceptance, loss of employment and unemployment, misconceptions and unintended pregnancies; while mobility hindrances included; restricted movement, high transport costs, and difficulty in finding transport. Conclusion Results showed that the pandemic had immediate and significant long-term effects on family planning service accessibility, utilization and delivery. The study recommends implementation of telehealth services, country-wide sensitization on use of long-term contraceptive methods, empowering village health teams and making family planning services mandatory and free to all private facilities in order to lower any disruptions during pandemics.
The Effect of Household Characteristics on Child Mortality in Uganda
(American Journal of Sociological Research, 2013) Kabagenyi, Allen; Rutaremwa, Gideon
The objective of this study was to establish the relationship between household characteristics and mortality among children under the ages of five in Uganda. Uganda in 2006experienced a high infant mortality rate of 76 deaths per 1000, far above the world’s average of 52 deaths /1000 live births. Of the infants that survive to the first birthday, 67 out of 1000 died before reaching their fifth birthday. In order to address this problem, the authors used survey data on 4,169 women respondents drawn from 14 districts of Uganda where the Uganda Ministry of Health intended to implement the Health Sector Strategic Plan II (2005/06 – 2009/10). Brass-type indirect techniques for mortality estimation were employed to establish the mortality rates. In addition, logistic regression analysis examined factors related with child mortality. Findings show wide mortality differentials by household type, place of residence, and household size. Mother’s education and children ever born were the two major variables highly associated with child mortality. The study concludes that household structure was not related to child mortality. There is need for adult literacy, secondary and above education for women and sensitization about the effects of large households and children ever born. Such studies provide insight into understanding the relationship between various household characteristics and child health outcomes.
Empowerment, intimate partner violence and skilled birth attendance among women in rural Uganda
(Reproductive health, 2016) Kwagala, Betty; Nankinga, Olivia; Ojiambo Wandera, Stephen; Ndugga, Patricia; Kabagenyi, Allen
There is limited research on how the empowerment of women and intimate partner violence (IPV) are associated with skilled birth attendance (SBA) among rural women in Uganda. Therefore, the aim of this paper was to investigate the association between women’s empowerment, their experience of IPV and SBA in rural Uganda. Methods: Using data from the Uganda Demographic and Health Survey (UDHS), we selected 857 rural women who were in union, had given birth in the last 5 years preceding the survey and were selected for the domestic violence (DV) module. Frequency distributions were used to describe the background characteristics of the women and their partners. Pearson’s chi-squared (χ2) tests were used to investigate the associations between SBA and women’s empowerment; and partners’ and women’s socio-demographic factors including sexual violence. Multivariable logistic regression analyses were used to examine the association between SBA and explanatory variables. Results: More than half (55 %) of the women delivered under the supervision of skilled birth attendant. Women’s empowerment with respect to participation in household decision-making, property (land and house) (co)ownership, IPV, and sexual empowerment did not positively predict SBA among rural women in Uganda. Key predictors of SBA were household wealth status, partners’ education, ANC attendance and parity. Conclusions: For enhancement of SBA in rural areas, there is a need to encourage a more comprehensive ANC attendance irrespective of number of children a woman has; and design interventions to enhance household wealth and promote men’s education.
Empowerment, partner’s behaviours and intimate partner physical violence among married women in Uganda
(BMC public health, 2013) Kwagala, Betty; Ojiambo Wandera, Stephen; Ndugga, Patricia; Kabagenyi, Allen
There is dearth of knowledge and research about the role of empowerment, partners’ behaviours and intimate partner physical violence (IPPV) among married women in Uganda. This paper examined the influence of women’s empowerment and partners’ behaviours on IPPV among married women in Uganda. Methods: The 2011 Uganda Demographic and Health Survey data were used, selecting a weighted sample of 1,307 women in union considered for the domestic violence module. Cross tabulations (chi-square tests) and multivariate logistic regressions were used to identify factors associated with IPPV. Results: The prevalence of IPPV among women in union in Uganda is still high (41%). Women’s occupation was the only measure of empowerment that was significantly associated with IPPV, where women in professional employment were less likely to experience IPPV. Women from wealthy households were less likely to experience IPPV. IPPV was more likely to be reported by women who had ever had children and witnessed parental IPPV. IPPV was also more likely to be reported by women whose husbands or partners: accused them of unfaithfulness, did not permit them to meet female friends, insisted on knowing their whereabouts and sometimes or often got drunk. Women who were afraid their partners were also more likely to report IPPV.
Facilitators, best practices and barriers to integrating family planning data in Uganda’s health management information system
(BMC health services research, 2019) Ojiambo Wandera, Stephen; Kwagala, Betty; Nankinga, Olivia; Ndugga, Patricia; Kabagenyi, Allen; Adamou, Bridgit; Kachero, Benjamin
Health management information systems (HMIS) are instrumental in addressing health delivery problems and strengthening health sectors by generating credible evidence about the health status of clients. There is paucity of studies which have explored possibilities for integrating family planning data from the public and private health sectors in Uganda’s national HMIS. This study sought to investigate the facilitators, best practices and barriers of integrating family planning data into the district and national HMIS in Uganda. Methods: We conducted a qualitative study in Kampala, Jinja, and Hoima Districts of Uganda, based on 16 key informant interviews and a multi-stakeholder dialogue workshop with 11 participants. Deductive and inductive thematic methods were used to analyze the data. Results: The technical facilitators of integrating family planning data from public and private facilities in the national and district HMIS were user-friendly software; web-based and integrated reporting; and availability of resources, including computers. Organizational facilitators included prioritizing family planning data; training staff; supportive supervision; and quarterly performance review meetings. Key behavioral facilitators were motivation and competence of staff. Collaborative networks with implementing partners were also found to be essential for improving performance and sustainability. Significant technical barriers included limited supply of computers in lower level health facilities, complex forms, double and therefore tedious entry of data, and web-reporting challenges. Organizational barriers included limited human resources; high levels of staff attrition in private facilities; inadequate training in data collection and use; poor culture of information use; and frequent stock outs of paper-based forms. Behavioral barriers were low use of family planning data for planning purposes by district and health facility staff.
Factors Associated with COVID-19 Vaccine Hesitancy in Uganda: A Population-Based Cross-Sectional Survey
(International Journal of General Medicine, 2022) Kabagenyi, Allen; Wasswa, Ronald; Nannyonga, Betty K.; Nyachwo, Evelyne B.; Kagirita, Atek; Nabirye, Juliet; Atuhaire, Leonard; Waiswa, Peter
Vaccination toward coronavirus disease (COVID-19) has been recommended and adopted as one of the measures of reducing the spread of this novel disease worldwide. Despite this, vaccine uptake among the Ugandan population has been low with reasons surrounding this being unknown. This study aimed to investigate the factors associated with COVID-19 vaccine hesitancy in Uganda. Methods: A cross-sectional study was conducted on a total of 1042 adults in the districts of Mukono, Kiboga, Kumi, Soroti, Gulu, Amuru, Mbarara and Sheema from June to November 2021. Data were analyzed using STATA v.15. Barriers to vaccination were analyzed descriptively, while a binary logistic regression model was used to establish the factors associated with COVID-19 vaccine hesitancy. Results: Overall, COVID-19 vaccine hesitancy was 58.6% (611). Respondents from urban areas and those in the eastern or northern region had increased odds of vaccine hesitancy. Further, higher education level and having knowledge on how COVID-19 is transmitted significantly reduced the odds of vaccine hesitancy. The study also noted individual perception such as COVID-19 kills only people with underlying medical conditions, as well as limited awareness on vaccine types or vaccination areas as the main reasons to vaccine hesitancy. Relatedly, other misconceptions like the ability of the vaccine to cause infertility, or spreading the virus into the body, and acknowledgment of alcohol as a possible cure were other reasons for vaccine hesitancy. Conclusion: The proportion of COVID-19 vaccine hesitancy is still high among the population with this varying across regions. This is driven by low education level and limited awareness on the vaccination as well as perceived myths and misconceptions. The study recommends mass sensitization of the population on the benefits of vaccination using various channels as well as rolling out community-based outreach vaccination campaigns across the country.
Family planning counseling during antenatal care and postpartum contraceptive uptake in Africa: a systematic review protocol
(JBI Evidence Synthesis, 2016) Sempeera, Hassard; Kabagenyi, Allen; Anguzu, Ronald; Muhumuza, Christine; Hassen, Kalkidan; Sudhakar, Morankar
omen in low-income countries face a greater risk of unwanted pregnancy and unsafe abortions compared with women in developed countries. This increased risk has been attributed to the high demand and limited access to family planning services by women in this setting. Research shows that one in every four women aged 15–49 years who are married or in a relationshipwould wish to timeor control their child bearing but are not using any method of family planning. Despite the fact that contraceptive use has a direct and positive impact on reducing global maternal deaths by almost a third each year, this opportunity has not been fully exploited in lowincome countries particularly those in Africa.

Browsing by Author "Kabagenyi, Allen"

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