NRU :: Browsing by Author "Katahoire, Anne R."

Browsing by Author "Katahoire, Anne R."

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Availability, functionality and access of blood pressure machines at the points of care in public primary care facilities in Tororo district, Uganda
(South African Family Practice, 2021) Besigye, Innocent K.; Okuuny, Vicent; Armstrong-Hough, Mari; Katahoire, Anne R.; Sewankambo, Nelson K.; Mash, Robert; Katamba, Achilles
Early diagnosis of hypertension prevents a significant number of complications and premature deaths. In resource-variable settings, diagnosis may be limited by inadequate access to blood pressure (BP) machines. We sought to understand the availability, functionality and access of BP machines at the points of care within primary care facilities in Tororo district, Uganda. Methods: This was an explanatory sequential mixed-methods study combining a structured facility checklist and key informant interviews with primary care providers. The checklist was used to collect data on availability and functionality of BP machines within their organisational arrangements. Key informant interviews explored health providers’ access to BP machines. Results: The majority of health facilities reported at least one working BP machine. However, Health providers described limited access to machines because they are not located at each point of care. Health providers reported borrowing amongst themselves within their respective units or from other units within the facility. Some health providers purchase and bring their own BP machines to the health facilities or attempted to restore the functionality of broken ones. They are motivated to search the clinic for BP machines for some patients but not others based on their perception of the patient’s risk for hypertension. Conclusion: Access to BP machines at the point of care was limited. This makes hypertension screening selective based on health providers’ perception of the patients’ risk for hypertension. Training in proper BP machine use and regular maintenance will minimise frequent breakdowns.
Community and District Empowerment for Scale-up (CODES): a complex district-level management intervention to improve child survival in Uganda: study protocol for a randomized controlled trial
(Trials, 2016) Waiswa, Peter; O’Connell, Thomas; Bagenda, Danstan; Mullachery, Pricila; Mpanga, Flavia; Kiwanuka, Dorcus H.; Katahoire, Anne R.; Ssegujja, Eric; Mbonye, Anthony K.; Peterson, Stefan S.
Background: Innovative and sustainable strategies to strengthen districts and other sub-national health systems and management are urgently required to reduce child mortality. Although highly effective evidence-based and affordable child survival interventions are well-known, at the district level, lack of data, motivation, analytic and planning capacity often impedes prioritization and management weaknesses impede implementation. The Community and District Empowerment for Scale-up (CODES) project is a complex management intervention designed to test whether districts when empowered with data and management tools can prioritize and implement evidence-based child survival interventions equitably. Methods: The CODES strategy combines management, diagnostic, and evaluation tools to identify and analyze the causes of bottlenecks to implementation, build capacity of district management teams to implement contextspecific solutions, and to foster community monitoring and social accountability to increase demand for services. CODES combines UNICEF tools designed to systematize priority setting, allocation of resources and problem solving with Community dialogues based on Citizen Report Cards and U-Reports used to engage and empower communities in monitoring health service provision and to demand for quality services. Implementation and all data collection will be by the districts teams or local Community-based Organizations who will be supported by two local implementing partners. The study will be evaluated as a cluster randomized trial with eight intervention and eight comparison districts over a period of 3 years. Evaluation will focus on differences in uptake of child survival interventions and will follow an intention-to-treat analysis. We will also document and analyze experiences in implementation including changes in management practices
Epidemiology of HPV genotypes in Uganda and the role of the current preventive vaccines: A systematic review
(Infectious Agents and Cancer, 2011) Banura, Cecily; Mirembe, Florence M.; Katahoire, Anne R.; Namujju, Proscovia B.; Mbonye, Anthony K.; Wabwire, Fred M.
Limited data are available on the distribution of human papillomavirus (HPV) genotypes in the general population and in invasive cervical cancer (ICC) in Uganda. Yet, with the advent of preventive HPV vaccines that target HPV 16 and 18 responsible for causing about 70% of ICC cases in the world, such information is crucial to predict how vaccination and HPV-based screening will influence prevention of ICC. To review the distribution of HPV infection and prevalent genotypes, electronic databases (e.g. PubMed/ MEDLINE and HINARI) were searched for peer reviewed English articles on HPV infection up to November 30, 2010. Eligible studies were selected according to the following criteria: DNA-confirmed cervical or male genital HPV prevalence and genotypes, HPV incidence estimates and HPV seroprevalence among participants.
Improving child survival through a district management strengthening and community empowerment intervention: early implementation experiences from Uganda
(BMC public health, 2015) Katahoire, Anne R.; Kiwanuka, Dorcus H.; Ssegujja, Eric; Waiswa, Peter; Ayebare, Florence; Bagenda, Danstan; Mbonye, Anthony K.; Peterson, Stefan S.
Background: The Community and District Empowerment for Scale-up (CODES) project pioneered the implementation of a comprehensive district management and community empowerment intervention in five districts in Uganda. In order to improve effective coverage and quality of child survival interventions CODES combines UNICEF tools designed to systematize priority setting, allocation of resources and problem solving with Community dialogues based on Citizen Report Cards and U-Reports used to engage and empower communities in monitoring health service provision and to demand for quality services. This paper presents early implementation experiences in five pilot districts and lessons learnt during the first 2 years of implementation. Methods: This qualitative study was comprised of 38 in-depth interviews with members of the District Health Teams (DHTs) and two implementing partners. These were supplemented by observations during implementation and documents review. Thematic analysis was used to distill early implementation experiences and lessons learnt from the process. Results: All five districts health teams with support from the implementing partners were able to adopt the UNICEF tools and to develop district health operational work plans that were evidence-based. Members of the DHTs described the approach introduced by the CODES project as a more systematic planning process and very much appreciated it. Districts were also able to implement some of the priority activities included in their work plans but limited financial resources and fiscal decision space constrained the implementation of some activities that were prioritized. Community dialogues based on Citizen Report Cards (CRC) increased community awareness of available health care services, their utilization and led to discussions on service delivery, barriers to service utilization and processes for improvement. Community dialogues were also instrumental in bringing together service users, providers and leaders to discuss problems and find solutions. The dialogues however are more likely to be sustainable if embedded in existing community structures and conducted by district based facilitators. U report as a community feedback mechanism registered a low response rate. Conclusion: The UNICEF tools were adopted at district level and generally well perceived by the DHTs. The limited resources and fiscal decision space however can hinder implementation of prioritized activities. Community dialogues based on CRCs can bring service providers and the community together but need to be embedded in existing community structures for sustainability.
Prevalence, associated factors and perspectives of HIV testing among men in Uganda
(PLoS ONE, 2020) Nangendo, Joanita; Katahoire, Anne R.; Armstrong-Hough, Mari; Kabami, Jane; Odei Obeng-Amoako, Gloria; Muwema, Mercy; Semitala, Fred C.; Karamagi, Charles A.; Wanyenze, Rhoda K.; Kamya, Moses R.; Kalyango, Joan N.
Despite overall increase in HIV testing, more men than women remain untested. In 2018, 92% of Ugandan women but only 67% of men had tested for HIV. Understanding men’s needs and concerns for testing could guide delivery of HIV testing services (HTS) to them. We assessed the prevalence of testing, associated factors and men’s perspectives on HIV testing in urban and peri-urban communities in Central Uganda. Methods and findings We conducted a parallel-convergent mixed-methods study among men in Kampala and Mpigi districts from August to September 2018. Using two-stage sampling, we selected 1340 men from Mpigi. We administered a structured questionnaire to collect data on HIV testing history, socio-demographics, self-reported HIV risk-related behaviors, barriers and facilitators to HIV testing. We also conducted 10 focus-groups with men from both districts to learn their perspectives on HIV testing. We used modified Poisson regression to assess factors associated with HIV testing and inductive thematic analysis to identify barriers and facilitators. Though 84.0% of men reported having tested for HIV, only 65.7% had tested in the past 12-months despite nearly all (96.7%) engaging in at least one HIV risk-related behavior. Men were more likely to have tested if aged 25–49 years, Catholic, with secondary or higher education and circumcised. Being married was associated with ever-testing while being widowed or divorced was associated with testing in past 12-months.
Quality of life and Associated Factors among Children aged 5 to 18 years with Diabetes Mellitus at St. Francis Hospital Nsambya and Mulago National Referral Hospital
(International Journal of Diabetes & Metabolic Disorders, 2019) Mulungi-Bibangambah, Esther Nabatanzi; Mworozi, Edison Arwanire; Nyangabyaki, Catherine; Katahoire, Anne R.
This study aimed to determine the quality of life and describe associated factors among children aged 5-18 years with diabetes Mellitus at St. Francis Hospital Nsambya and Mulago National Referral Hospital. An explanatory sequential study design was used between November 2018 and March 2019. Univariate analysis together with bivariate logistic regression analysis was used to determine quality of life and identify association between the quality of life at a p-value �? 0.05 respectively. Factors found to have a p-value �? 0.25 were included in the Multivariate logistic regression. A backward method was then applied to determine the best model that predicts quality of life among children. Data was analysed using STATA version 14. Data on the perception of quality of life of children with diabetes mellitus from the perspective of the children, caregivers and health workers was used to obtain qualitative results. 115 children were recruited from the paediatric diabetic clinics. A low quality of life with a mean score of 77 ±15.58 was reported with a mean age of 13 ± 3.9. Factors associated with quality of life included: age groups of 8-12 and 13-18 years, primary education, secondary education, tertiary education, a single parent, living with relatives and primary care giver being a relative other than the biological parents. A sub-optimal quality of life was observed among children with type 1 diabetes mellitus. The factors associated with good quality of life included; age between 5- 7 years, a child living with biological parents, a child being in primary school and higher parental level of education.
Stigma mastery in people living with HIV: gender similarities and theory
(Journal of Public Health, 2022) Namisi, Charles P.; Munene, John C.; Wanyenze, Rhoda K.; Katahoire, Anne R.; Parkes-Ratanshi, Rosalinda M.; Kentutsi, Stella; Nannyonga, Maria M.; Ssentongo, Robina N.; Ogola, Mabel K.; Nabaggala, Maria S.; Amanya, Geofrey; Kiragga, Agnes N.; Batamwita, Richard; Tumwesigye, Nazarius M.
Aims This study aimed to determine the prevalence of, factors associated with, and to build a theoretical framework for understanding Internalsed HIV-related Stigma Mastery (IHSM). Methods A cross-sectional study nested within a 2014 Stigma Reduction Cohort in Uganda was used. The PLHIV Stigma Index version 2008, was used to collect data from a random sample of 666 people living with HIV (PLHIV) stratified by gender and age. SPSS24 with Amos27 softwares were used to build a sequential-mediation model. Results The majority of participants were women (65%), aged ≥ 40 years (57%). Overall, IHSM was 45.5% among PLHIV, that increased with age. Specifically, higher IHSM correlated with men and older women “masculine identities” self-disclosure of HIV-diagnosis to family, sharing experiences with peers. However, lower IHSM correlated with feminine gender, the experience of social exclusion stress, fear of future rejection, and fear of social intimacy. Thus, IHSMsocial exclusion with its negative effects and age-related cognition are integrated into a multidimensional IHSM theoretical framework with a good model-to-data fit. Conclusion Internalised HIV-related Stigma Mastery is common among men and older women. Specificially, “masculine identities” self-disclose their own HIV-positive diagnosis to their family, share experiences with peers to create good relationships for actualising or empowerment in stigma mastery. However, social exclusion exacerbates series of negative effects that finally undermine stigma mastery by young feminine identities. Thus, stigma mastery is best explained by an integrated empowerment framework, that has implications for future practice, policy, and stigma-related research that we discuss.
Universal routine HPV vaccination for young girls in Uganda: a review of opportunities and potential obstacles
(Infectious Agents and Cancer, 2012) Banura, Cecily; Mirembe, Florence M.; Katahoire, Anne R.; Namujju, Proscovia B.; Mbidde, Edward K.
This article reviews the existing realities in Uganda to identify opportunities and potential obstacles of providing universal routine HPV vaccination to young adolescent girls. Cervical cancer is a public health priority in Uganda where it contributes to about 50–60% of all female malignancies. It is associated with a dismal 5-year relative survival of approximately 20%. With adequate financial resources, primary prevention through vaccination is feasible using existing education and health infrastructure. Cost-effectiveness studies show that at a cost of US$2 per dose, the current vaccines would be cost effective. With optimal (≥70%) coverage of the target population, the lifetime risk of cervical cancer could be reduced by >50%. Uganda fulfils 4 out of the 5 criteria set by the WHO for the introduction of routine HPV vaccination to young adolescent girls. The existing political commitment, community support for immunization and the favorable laws and policy environment all provide an opportunity that should not be missed to introduce this much needed vaccine to the young adolescent girls. However, sustainable financing by the government without external assistances remains a major obstacle. Also, the existing health delivery systems would require strengthening to cope with the delivery of HPV vaccine to a population that is normally not targeted for routine vaccination. Given the high incidence of cervical cancer and in the absence of a national screening program, universal HPV vaccination of Ugandan adolescent girls is critical for cervical cancer prevention.

Browsing by Author "Katahoire, Anne R."

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