Browsing by Author "Namuhani, Noel"
Now showing 1 - 4 of 4
Results Per Page
Sort Options
Item Equity in family planning policies and programs in Uganda: conceptualization, dimensions and implementation constraints(BioMed Central Ltd, 2024-03) Namuhani, Noel; Wanyenze, Rhoda K; Kiwanuka, Suzanne N ; Matovu, Joseph K B; Makumbi, Fredrick EEquity is at the core and a fundamental principle of achieving the family planning (FP) 2030 Agenda. However, the conceptualization, definition, and measurement of equity remain inconsistent and unclear in many FP programs and policies. This paper aims to document the conceptualization, dimensions and implementation constraints of equity in FP policies and programs in Uganda. A review of Ugandan literature and key informant interviews with 25 key stakeholders on equity in FP was undertaken between April and July 2020. We searched Google, Google Scholar and PubMed for published and grey literature from Uganda on equity in FP. A total of 112 documents were identified, 25 met the inclusion criteria and were reviewed. Data from the selected documents were extracted into a Google master matrix in MS Excel. Data analysis was done across the thematic areas by collating similar information. Data were analyzed using thematic content analysis approach. A limited number of documents had an explicit definition of equity, which varied across documents and stakeholders. The definitions revolved around universal access to FP information and services. There was a limited focus on equity in FP programs in Uganda. The dimensions most commonly used to assess equity were either geographical location, or socio-demographics, or wealth quintile. Almost all the key informants noted that equity is a very important element, which needs to be part of FP programming. However, implementation constraints (e.g. lack of quality comprehensive FP services, duplicated FP programs and a generic design of FP programs with limited targeting of the underserved populations) continue to hinder effective implementation of equitable FP programs in Uganda. Clients' constraints (e.g. limited contraceptive information) and policy constraints (inadequate focus on equity in policy documents) also remain key challenges. There is lack of a common understanding and definition of equity in FP programs in Uganda. There is need to build consensus on the definitions and measurements of equity with a multidimensional lens to inform clear policy and programming focus on equity in FP programs and outcomes. To improve equitable access to and use of FP services, attention must be paid to addressing implementation, client and policy constraints.Item Jigger Persistence and Associated Factors among Households in Mayuge District, Uganda(International Journal of Health Sciences and Research (IJHSR), 2016) Namuhani, Noel; Kiwanuka, Suzanne N.Jigger infestation has serious health consequences and has been associated with considerable morbidity and difficulties in walking or using the hands, which prevent the victims from leading productive life. Persistent jigger infestation produces even more dire outcomes such as disability and mortality due to secondary infections. In Uganda, jigger infestation has been reported to be at epidemic levels and has persisted especially in the rural communities of the country, some households being at a higher risk of Persistent Jigger Infestation than others. This study aimed at assessing factors associated with persistent jigger infestation among households of Mayuge district, Uganda. Methods: A total of 296 households in Bukatube Sub County, Mayuge district, were randomly selected to participate in the study. Persistent Jigger infestation was defined as individuals who experienced at least four jigger re- infestations within the past 30 days. Semi structured questionnaires, observational checklists and key informant interview guides were used to collect data. Data was analyzed using Epi info version 3.5.1, descriptive statistics were obtained, bi variable and multivariable analysis was done, to examine the association between the different variables. Results: The prevalence of jigger infestation was found to be 25.0%, but of these, 58.3% had persistent jigger infestation. Factors that increased the likely hood of persistent jigger infestation included; low monthly income (AOR 2.84 95%CI 1.04-7.75), littered compound (AOR 5.18, 95%CI 2.56-10.46), earthen floor (AOR 3.38 95%1.08-10.55), and cracked walls (AOR 4.63 95%CI 2.23-9.60). Individuals who were knowledgeable about jigger prevention had reduced chances of being persistently infested with jiggers (AOR 0.47 95%CI 0.25-0.90). Conclusion: The prevalence of jigger infestation and the level of persistence were moderately high. There is need to increase awareness of community members on how to control jiggers and appropriate measures to address the nature of houses that people live in, need to be implemented.Item Laboratory Diagnostics Performance in Uganda: A Survey of Test Availability and Constraints Across 100 Laboratories(Research Square, 2021) Namuhani, Noel; Kiwanuka, Suzanne N.; Akulume, Martha; Kalyesubula, Simeon; Bazeyo, William; Kisakye, Angela N.Clinical laboratory services are a critical component of the health system for effective disease diagnosis, treatment, control and prevention. However, many laboratories in Sub Saharan Africa remain dysfunctional. The high costs of tests in the private sector also remain a hindrance to accessing testing services. This study aimed at assessing the functionality of laboratories based on test menus and the associated constraints in Uganda. Methods This cross sectional quantitative study involved an assessment of 100 laboratories randomly selected in 20 districts from four regions of the country. Sixteen percent of the studied laboratories were regional hub laboratories. Laboratory in charges and managers in each of the selected laboratories were interviewed. A checklist for laboratory supplies adapted from the Essential Medicines and Health supplies list for Uganda, (2012) was used to assess availability of testing supplies. Data was analyzed using excel and STATA 14. Results At the point of assessment, generally, all laboratories were able to perform malaria tests and HIV tests. All the hub laboratories conducted malaria tests and TB screening. Less than half had electrolytes tests due to lack of equipment, nonfunctioning equipment and lack of reagents. Full blood count tests were missing in 25% of the hub laboratories mainly due to lack of equipment. The lack of reagents (66.7%) and the lack of equipment (58.3%) caused the majority 10/16 of the hubs to routinely referred specimens for tests that are supposed to be carried out in these laboratories due to lack of reagents (66.7%) and non-functional equipment (58.3%). Although officially recognized as an operational structure, Hub laboratories lacked a list of essential and vital supplies. Conclusions Most laboratories performed well for the common tests. However, many laboratories did not meet testing requirements especially for the advanced tests according to standard testing menus for Uganda due to non-functioning equipment, lack of equipment and reagents. Hubs lack list of essential supplies. Therefore, there is need to provide equipment to laboratories, repair the non-functional ones and develop an essential list of supplies for the hub laboratories.Item Uganda’s laboratory human resource in the era of global health initiatives: experiences, constraints and opportunities—an assessment of 100 facilities(Human Resources for Health, 2020) Kiwanuka, Suzanne N.; Namuhani, Noel; Akulume, Martha; Kalyesubula, Simeon; Bazeyo, William; Kisakye, Angela N.Laboratories are vital in disease diagnosis, prevention, treatment and outbreak investigations. Although recent decades have seen rapid advancements in modernised equipment and laboratory processes, minimal investments have been made towards strengthening laboratory professionals in Africa. This workforce is characterised by insufficient numbers, skewed rural-urban distribution, inadequate qualifications, inadequate skill-mix and limited career opportunities. These factors adversely affect the performance of laboratory professionals, who are the backbone of quality services. In the era of Global Health Initiatives, this study describes the status of laboratory human resource and assesses the experiences, constrains and opportunities for strengthening them in Uganda. Methods: This paper is part of a study, which assessed laboratory capacity in 21 districts during December 2015 to January 2016. We collected data using a laboratory assessment tool adapted from the WHO and USAID assessment tool for laboratory services and supply chain (ATLAS), 2006. Of the 100 laboratories, 16 were referral laboratories (hubs). To assess human resource constraints, we conducted 100 key informant interviews with laboratory managers and in charges. Results: Across the facilities, there was an excess number of laboratory technicians at Health Center (HC) IV level by 30% and laboratory assistants were in excess by 90%. There was a shortage of laboratory technologists with only 50% of the posts filled at general hospitals. About 87.5% of hub laboratories had conducted formal onsite training compared to 51.2% of the non-hub laboratories. Less than half of HC III laboratories had conducted a formal onsite training; hospital laboratories had not conducted training on the use and maintenance of equipment. Almost all HC III laboratories had been supervised though supervision focused on HIV/AIDS. Financial resources, workload and lack of supervision were major constraints to human resource strengthening. Conclusion: Although opportunities for continuous education have emerged over the past decade, they are still threatened by inadequate staffing, skill mix and escalating workload. Moreover, excesses in staffing are more in favour of HIV, TB and malaria. The Ministry of Health needs to develop work-based staffing models to ensure adequate staff numbers and skill mix. Staffing norms need to be revised to accommodate laboratory technologists and scientists at high-level laboratories. Training needs to extend beyond HIV, TB and malaria.