Browsing by Author "Nabirye, Rose Chalo"

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    Cervical Cancer Screening among HIV‑Positive Women in Urban Uganda: A Cross Sectional Study
    (BMC Women's Health, 2022) Najjuka, Sarah Maria; Olwit, Connie; Kaggwa, Mark Mohan; Nabirye, Rose Chalo; Ngabirano, Tom Denis
    Women living with Human Immunodeficiency Virus (HIV) are at a high risk for early development of cervical cancer. Adherence to cervical cancer prevention strategies in this population is vital for the early detection and treatment of cervical cancer. This study aimed to determine the prevalence and factors associated with cervical cancer screening among HIV-positive women attending an urban HIV care center in Uganda.This cross-sectional study included 205 HIV-positive women receiving care at an urban HIV care center. An interviewer-administered questionnaire was used to capture sociodemographic information, history of screening for cervical cancer, and reproductive health characteristics. Logistic regression analysis was used to determine the factors associated with cervical cancer screening.Of the 205 HIV-positive women with a mean age of 37.5 ± 8.87 that participated in the study, majority (n = 201, 98%) were aware of cervical cancer screening. Ninety participants (44%) had ever been screened for cervical cancer and only 33 (16.1%) had been screened in the past year. Obtaining information about cancer of the cervix and cervical cancer screening from health care professionals was significantly associated with higher levels of cervical cancer screening (adjusted odds ratio = 5.61, 95% confidence interval: 2.50–12.61, p value < 0.001).This study highlights the low prevalence of cervical cancer screening among HIV-positive women and underscores the role of health professionals as an effective source of information on cervical cancer and cervical cancer screening. Patient education programs in HIV prevention and care facilities should emphasize cervical cancer screening messages to enhance the uptake of screening services.
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    Enablers and barriers of male involvement in the use of modern family planning methods in Eastern Uganda: a qualitative study
    (Contraception and Reproductive Medicine, 2023-10-16) Tekakwo, Atkinson; Nabirye, Rose Chalo; Oguttu, Faith; Mukunya, David; Epuitai, Joshua
    Male involvement plays a critical role in the utilization of various sexual and reproductive health services. We explored enablers and barriers of male involvement in the use of modern family planning methods in Eastern Uganda. This was a qualitative study in Mbale, Eastern Uganda done between November and December 2022. We conducted three group discussions comprising of four participants each, with male partners and eight key informant interviews with midwives. We followed a group discussion guide during the group discussions and an interview guide during the key informant interviews to explore enablers and barriers of male involvement in the use of modern family planning methods. All the interviews and group discussions were audio-recorded with permission from the participants, transcribed verbatim, and analyzed following thematic content analysis approach. Two sub-themes emerged from the analysis; perceived enablers and barriers. The perceived enablers included positive attitude, subjective norms, need to support the woman, mutual consent, limited resources and expected benefits of reducing gender-based violence and sexually transmitted infections. Lack of male partner consent, busy work engagement, social stigma, religious prohibition, desire for many children and gender roles incompatibility hindered male partner involvement in family planning. Fear of side effects and misconceptions, unconducive hospital environment in form of mistreatment, family planning considered a female’s issue, and lack of consideration of male partner needs in family planning clinic were additional barriers to male involvement. Male involvement in family planning was related to positive attitude and subjective norms towards family planning, mutual consent, and recognition for limited resources to support a large family size. Lack of male partner approval, fear of side effects and misconceptions, unconducive hospital environment and social, cultural and religious prohibitions discouraged male partner involvement in family planning. Community based approaches to family planning sensitization, such as community education campaigns, may be an important step toward reducing barriers to male involvement in the use of modern family planning methods.
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    “I felt my rights were violated”: Challenges with the discontinuation of provider‑dependent contraceptive methods in Eastern Uganda
    (Contraception and Reproductive Medicine, 2025-03-18) Nabulondera, Agnes; Nabirye, Rose Chalo; Akello, Sarah Racheal; Munanura, Turyasiima; Epuitai, Joshua
    The right to autonomy in family planning is a cornerstone of reproductive health. Yet, many women face challenges when seeking to discontinue provider-dependent contraceptive methods, such as implants and intrauterine devices (IUDs). This study explored the experiences of women in Eastern Uganda regarding the discontinuation of implants/IUDs. Using a qualitative descriptive design, we conducted 15 in-depth interviews with women and six key informant interviews with healthcare providers. The study obtained ethical clearance and used a thematic analysis. Two themes were identified: (1) reasons for refusal and (2) women’s reactions to refusal to discontinue IUDs/implants. Women were denied to discontinue IUDs/implants because the due date had not been reached, insertion cards were missing, and there were healthcare constraints, especially inadequate equipment. Early removal or discontinuation before the due date was considered as a waste of resources, unjustifiable, and it was seen to increase risk of pregnancy among young girls. Healthcare workers preferred to first counsel for side effects instead of heeding women's requests to discontinue IUDs/implants. Women often felt betrayed and powerless when they were denied to discontinue using IUDs/implants. They felt that their reproductive rights were undermined which fostered mistrust towards future use of provider-dependent contraceptives. Women reported physical, social, and mental health struggles including strained marital relationships following denial to discontinue IUDs/implants. Most of the women incurred costs in discontinuing the use of IUDs/implants in private facilities. The findings underscore the need to uphold women’s autonomy by improving access to removal services, and addressing systemic and provider-level barriers to discontinuation of IUDs/implants. Insertion cards should not be a mandatory requirement during discontinuation of contraceptives, while enhancing record-keeping systems can address the need for insertion cards. Respecting women’s rights to discontinue contraceptives is essential for ensuring voluntary and sustained family planning use.
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    I have come to remove it because of heavy bleeding”: a mixed-methods study on early contraceptive implant removal and the underlying factors in eastern Uganda
    (BioMed Central Ltd, 2024-04) Abiyo, Janet; Nabirye, Rose Chalo; Nambozo, Brendah; Mukunya, David; Nantale, Ritah; Oguttu, Faith; Wani, Solomon; Musaba, Milton W; Tumuhamye, Josephine; Epuitai, Joshua
    BACKGROUNDEarly contraceptive implant removal without intentions to conceive predisposes women to unintended pregnancies.. Some of the unintended pregnancies end in unsafe abortions which further increases the risk of maternal mortality and morbidity. Therefore, we assessed the proportion of women who had early contraceptive implant removal. We also explored the reasons for early contraceptive implant removalamong women at Mbale Regional Referral Hospital in eastern Uganda.METHODSWe conducted a sequential explanatory mixed methods study at Mbale Regional Referral Hospital between November 2022 to December 2022. For quantitative data, we performed a secondary analysis on data extracted from the integrated family planning registers. We used systematic random sampling to select 600 clients' serial numbers from the registers. The outcome variable was early contraceptive implant removal defined as removal of the implant by the woman before 18 months from the time of insertion. For qualitative data, we conducted 11 in-depth interviews among women who had come for contraceptive implant removal at the family planning clinic. We also conducted two key informant interviews with midwives working at the family planning unit. Quantitative data were analysed using Stata version 14.0 (Stata Corp LLC, College Station, Texas, USA) while qualitative data were analysed by thematic content analysis.RESULTSIn this study, 15% (91/600) of the women discontinued contraceptive implants within 12 months, 29% (175/600) within 18 months, 38% (230/600) within 24 months and 40% (240/600) within 36 months of insertion. Among the women who discontinued contraceptive implant use, only 6.7% (40/600) switched to another family planning method. Out of the 175 women who removed contraceptive implants early, side effects 61.1% (107/175) desire to conceive 53.1% ( 93/175),, and gender-based violence 8.6% (15/175) were the major reasons for removal. From the qualitative interviews, the major reasons for early contraceptive implant removal were side effects such as heavy menstrualbleeding.CONCLUSIONA third of women discontinued contraceptive implant use within 18 months. Addressing concerns regarding side effects and male partner disapproval of modern contraceptives may improve continued use of implants.
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    Intimate partner violence among pregnant women in Uganda
    (African Journal of Midwifery and Women's Health, 2019-04-13) Epuitai, Joshua; Udho, Samson; Auma, Anna Grace; Nabirye, Rose Chalo
    Intimate partner violence may be more prevalent during pregnancy as women are more vulnerable. To determine the prevalence of intimate partner violence and associated factors among pregnant women at Soroti Regional Referral Hospital, Uganda. A cross-sectional study was conducted among 180 pregnant women. Data were collected using a pre-tested, semi-structured questionnaire. Intimate partner violence was measured using the revised Conflict Tactile Scale 2. The overall prevalence of intimate partner violence during pregnancy was 27.8%. Household average monthly income, experiences of intimate partner violence before pregnancy and marital conflicts were independently associated with intimate partner violence during pregnancy. Screening should be done during antenatal care among women with low household income, marital conflicts, and history of intimate partner violence before pregnancy to identify and manage cases of intimate partner violence. More research is needed to identify interventions for reduction of intimate partner violence during pregnancy.
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    Midwives’ practice and perception of labour and delivery care at the Mulago National Referral Hospital, Uganda
    (African Journal of Midwifery and Women's Health, 2020-04-16) Namwaya, Ziidah; Namagembe, Imelda; Kaye, Dan; Nalwadda, Gorrette; Edwards, Grace; Nabirye, Rose Chalo
    The majority of maternal deaths occur during labour, delivery, or within the first 4 hours after birth. This can be reduced by the care that midwives provide. At Mulago Hospital, little is documented on midwives' current practice and their perception of care offered during labor and delivery. The number of maternal and neonatal deaths as a result of preventable causes such as postpartum haemorrhage, obstructed labour, ruptured uterus and sepsis remains high. The aim of this study was to document the current practice of midwives, explore midwives' perception towards practice and identify factors that influence practice during birth in Uganda, to identify possible areas for improvement. A cross-sectional study was conducted of midwives working in the three labour wards at the Mulago National referral hospital: the general ward, the private ward and the midwifery-led ward. Midwives' perceptions were explored using a semi-structured questionnaire, which asked midwives about their current practice and their perception of the care offered. Care was found to be lacking in several areas. Only one-fifth (20.0%) of midwives reported always checking temperature every 4 hours. Only 20.5% reported that women are always supported in being mobile during labour. Less than half of the midwives (44.4%) knew the recommended drugs for managing the third stage of labour. Infection prevention practices were poor. Only 54% of midwives knew how to prepare magnesium sulphate for management of severe pre-eclampsia and eclampsia. Overall, the general labour ward was found to have the most gaps in midwives' knowledge. Lack of continuing education, supplies, teamwork and clinical guidelines were reported to affect practice. Staff shortages and midwives' decisions being underlooked by obstetricians were also reported to affect practice. Overall, the study found that midwifery practice is suboptimal in key areas such as infection prevention, use of a partograph, and management of pre-eclampsia and eclampsia. Continuous professional development, provision of resources, and strengthening teamwork are recommended to improve maternal health outcomes at Mulago Hospital.
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    Perceptions of quality of care in Midwife-led Birth Centres (MLBCs) in Uganda: Why do women choose MLBCs over other options?
    (Women and Birth, 2024-07-25) Nabirye, Rose Chalo; Mbalinda, Scovia Nalugo; Nawagi , Faith; Bazirete, Oliva; Homer, Caroline S.E.
    Midwife-led birth centres (MLBCs) are associated with reduced childbirth interventions, higher satisfaction rates, and improved birth outcomes. The evidence on quality of care in MLBCs from low and middle-income countries (LMIC) is limited.