Browsing by Author "Namagembe, Imelda"

Now showing 1 - 5 of 5
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    Case studies from the experience of early career researchers in East Africa in building community engagement in research
    (AAS Open Research, 2022-06-27) Bargul , Joel L.; Namagembe, Imelda; Nakityo, Immaculate; Nakimuli , Annettee; Semakula,Daniel; Sewankambo, Nelson K.
    In this paper, we explain how three early career researchers actively engaged community members in their health research projects in Kenya, Tanzania and Uganda, and what was learnt from the experience. The research project in Kenya was on camel trypanosomiasis and the role of camel biting keds (or louse flies) in disease transmission. The project in Tanzania looked at the effect of human immunodeficiency virus and antiretroviral therapy on fertility and ascertained the trends in the use of family planning services amongst women of reproductive age. The focus of the project in Uganda was the implementation of maternal death surveillance and the response policy to determine the cause of maternal deaths and how they might be prevented.
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    Finding the best examples of healthcare quality improvement in Sub-Saharan Africa
    (BMJ Quality & Safety, 2010) Liu, Constance; Babigumira, Joseph; Chiunda, Allan; Katamba, Achilles; Litvak, Ilya; Miller, Lakisha; Namagembe, Imelda; Sekandi, Juliet; Seicean, Andrea; Seicean, Sinziana; Neuhauser, Duncan
    The purpose of this study was to summarise the current state of healthcare quality improvement literature focusing on sub-Saharan Africa. Methods Conventional methods of searching the literature were quickly found to be inadequate or inappropriate, given the different needs of practitioners in sub-Saharan Africa, and the inaccessibility of the literature. Results The group derived a core list of what were deemed exemplary quality improvement articles, based on consensus and a search into the “grey” literature of quality improvement. Conclusions Quality improvment articles from sub- Saharan Africa are difficult to find, and suffer from a lack of centrality and organisation of literature. Efforts to address this are critical to fostering the growth of quality improvement literature in developing country settings.
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    Implementation challenges in preeclampsia care: perspectives from health care professionals in urban Uganda
    (Elsevier Inc, 2024-05) Namagembe, Imelda; Karavadra, Babu; Kazibwe, Lawrence; Rujumba, Joseph; Kiwanuka, Noah; Smith, Brandon; Byamugisha, Josaphat; Moffett, Ashley; Bashford, Tom; Nakimuli, Annettee; Aiken, Catherine E.
    Sub-Saharan Africa bears the burden of 70% of maternal deaths worldwide, of which ∼10% are attributable to hypertensive disorders of pregnancy, primarily complications of preeclampsia. In other global settings, outcomes of pregnancies affected by preeclampsia are improved with timely and effective medical care. This study aimed to explore the perspectives of local health care professionals on how preeclampsia care is currently delivered in the study setting and what challenges they experience in providing prompt and safe care. We identified specific objectives of exploring stakeholder perceptions of (1) recognizing preeclampsia and (2) timely intervention when preeclampsia is diagnosed. We also explored the wider system factors (eg, cultural, financial, and logistic challenges) that health care professionals perceived as affecting their ability to deliver optimal preeclampsia care. Individual semistructured interviews were conducted with health care professionals and stakeholders. The findings were analyzed using thematic analysis. Thirty-three participants contributed to the study, including doctors and midwives with varying degrees of clinical experience and external stakeholders. The following 5 key themes emerged: delayed patient presentation, recognizing the unwell patient with preeclampsia, the challenges of the existing triage system, stakeholder disconnect, and ways of learning from each other. Health care professionals referenced an important psychosocial perspective associated with preeclampsia in the study setting, which may influence the likelihood of seeking care through traditional healers rather than hospital-based routes. We identify the key barriers to improving maternal and neonatal outcomes of preeclampsia, described at both the institutional level and within the wider setting. The study provides invaluable contextual information that suggests that a systems-based approach to health care quality improvement may be effective in reducing rates of maternal and neonatal morbidity and mortality.
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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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    The Luganda Edinburgh Postnatal depression scale: cross-cultural adaptation and validation for prenatal screening of depression in a Ugandan sample
    (African Journals Online (AJOL), 2025-01-11) Mukasa, David Christopher; Ononge, Sam; Namagembe, Imelda; Byamugisha, Josaphat; Sekikubo, Musa; Muyingo, Mark; Nakasujja, Noeline
    Background: Depression affects approximately 364 million people globally. Prenatal depression affects between 26.3% and 32.9% of mothers in Africa. Opportunities for prenatal screening are missed. The gold standard diagnostic, the Diagnostic and Statistical Manual of Mental Disorders-Fifth edition (DSM-5) criteria for Major Depressive Disorder (MDD) has higher technical requirement. There is inadequate information on locally adapted and validated user-friendly screening tools in Uganda. Objective: To Adapt and validate the Luganda Edinburgh Postnatal Depression Scale (EPDS-L) for screening prenatal depression at Kawempe National Referral hospital (KNRH). Methods: Cross-sectional study in KNRH using International Society for Pharmacoeconomics and Outcomes Research guidelines for adaptation and quantitative approaches for the validation. Consecutive sampling until the desired sample of 100, all participants responded to both EPDS-L and DSM-5 criteria for MDD. Reliability demonstrated using Cronbach’s alpha coefficient, while validity was demonstrated by sensitivity, specificity, Negative Predictive Value (NPV), Positive Predictive Value (PPV) and Area-Under-the-curve (AUC). Results: EPDS-L had Cronbach’s-Alpha of 0.8515. At cut-off of 13, sensitivity was 62.86%, specificity-100%, PPV-100% and NPV-83.3%. AUC was 0.99. Performance was better at cut-off of 10, with sensitivity-97.14% and specificity-98.46%. Conclusion: The EPDS-L is reliable at cut-off of 13 but performs even better at cut-off of 10. Keywords: Mental health; prenatal depression; Edinburgh Postnatal Depression Scale; Luganda.