Browsing by Author "Nshakira, Nathan"

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    The availability of drugs: what does it mean in Ugandan primary care
    (Health Policy, 2003) Jitta, Jessica; Whyte, Susan Reynolds; Nshakira, Nathan
    Availability of drugs is often considered the most important element in quality of health care in rural African settings. Using material collected through mainly qualitative methods, this article examines drug availability in six primary health care units in southeastern Uganda. Emphasis is on the differing perspectives of three categories of actors: health planners/managers; health workers; and users of health services. The main concern is the availability of choroquine and penicillin, especially injectable forms, and the needles and syringes for administering them. Health sector reforms have changed the conditions for managing, supplying, and using drugs through decentralization, user fees, and privatization. Patients were dissaatisfied when they were not able to obtain all drugs prescribeddd at the health unit. Government health units both compete with, and use, local commercial sources of drugs. They need to attract patients and, with user fees, they are more able to supplement the drug kit supplies provided through the Ministry of Health. There is a need to revise policy in light of the new situation. Dialogue and realism are needed in order to create policies that respect both good medical treatment standards and the concerns of frontline workers and their patients. The exercise of rethinking the meaning of drug availability in primary health care calls for methodologies examining the chenging context of health care and the positions of different categories of actors, at national and district setting, to appreciate gaps existing between drug policy and practice.
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    Level of and Factors Associated with Optimal Uptake of Intermittent Preventive Treatment for Malaria in Pregnancy at Private-Not-For profit Health Facilities in Kasese District
    (PLOS Global Public Health, 2024-04-13) Mutoro, Julius; Kafunjo, Justus Barageine; Eric-Kitutu, Freddy; Kalyango, Joan; Mumbere, Iving; Nshakira, Nathan
    Malaria in pregnancy poses a high risk of poor maternal and neonatal outcomes and WHO recommends IPTp. However, its uptake has remained sub-optimal among mothers who attend antenatal care at private-not-for-profit health facilities. This study determined the level of and factors associated with uptake Intermittent preventive treatment of malaria for pregnant women (IPTp) at private-not-for-profit (PNFP) health facilities in Kasese District, Uganda. This was a cross-sectional study involving 396 postpartum mothers in the postnatal wards of 8 PNFP health facilities in Kasese district was conducted in September 2022. One hospital and 2 Health Centre IVs were purposively selected and 5 Health Centre IIIs selected randomly. Mothers were consecutively selected and interviewer administered semi-structured questionnaires were used to collect the data. Data were entered in epi-data version 3.1, cleaned and analyzed using STATA version 14. Data were adjusted for clustering & modified poison regression was used to determine associations of the factors and the outcome. From the analysis, level of optimal uptake of IPTp was 51.5% CI = (46.6–56.4). Being married (aPR = 1.35, 95% CI = 1.06–1.7, p = 0.014), attending ANC more than 4 Visits (aPR = 1.29, 95%CI = 1.09–1.54, p<0.001) positively influence optimal uptake while not taking IPTp at recommended time intervals (aPR = 0.49, 95%CI = 0.39–0.62 p<0.001) and mothers paying for IPTp drugs themselves (aPR = 0.74, 95%CI = 0.57–0.97, p = 0.031) negatively influence optimal uptake. This moderate uptake of IPTp among pregnant mothers suggests insufficient protection of pregnant mothers against malaria. Efforts to improve Antenatal care attendance, taking IPTp at recommended time intervals, not paying for ITPp drugs and encouraging marriages should be intensified.
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    Level of and factors associated with optimal uptake of intermittent preventive treatment for malaria in pregnancy at private-not-forprofit health facilities in Kasese district
    (PLOS Global Public Health, 2024-04-03) Mutoro, Julius; Kafunjo, Justus Barageine; Kalyango, Joan; Nshakira, Nathan
    Malaria in pregnancy poses a high risk of poor maternal and neonatal outcomes and WHO recommends IPTp. However, its uptake has remained sub-optimal among mothers who attend antenatal care at private-not-for-profit health facilities. This study determined the level of and factors associated with uptake Intermittent preventive treatment of malaria for pregnant women (IPTp) at private-not-for-profit (PNFP) health facilities in Kasese District, Uganda. This was a cross-sectional study involving 396 postpartum mothers in the postnatal wards of 8 PNFP health facilities in Kasese district was conducted in September 2022. One hospital and 2 Health Centre IVs were purposively selected and 5 Health Centre IIIs selected randomly. Mothers were consecutively selected and interviewer administered semi-structured questionnaires were used to collect the data. Data were entered in epi-data version 3.1, cleaned and analyzed using STATA version 14. Data were adjusted for clustering & modified poison regression was used to determine associations of the factors and the outcome. From the analysis, level of optimal uptake of IPTp was 51.5% CI = (46.6–56.4). Being married (aPR = 1.35, 95% CI = 1.06–1.7, p = 0.014), attending ANC more than 4 Visits (aPR = 1.29, 95%CI = 1.09–1.54, p<0.001) positively influence optimal uptake while not taking IPTp at recommended time intervals (aPR = 0.49, 95%CI = 0.39–0.62 p<0.001) and mothers paying for IPTp drugs themselves (aPR = 0.74, 95%CI = 0.57–0.97, p = 0.031) negatively influence optimal uptake. This moderate uptake of IPTp among pregnant mothers suggests insufficient protection of pregnant mothers against malaria. Efforts to improve Antenatal care attendance, taking IPTp at recommended time intervals, not paying for ITPp drugs and encouraging marriages should be intensified.
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    Safety of Drinking Water from Primary Water Sources and Implications for the General Public in Uganda
    (Journal of Environmental and Public Health, 2019) Kasozi, Keneth Iceland; Namubiru, Sarah; Kamugisha, Roland; Eze, Ejike Daniel; Tayebwa, Dickson Stuart; Ssempijja, Fred; Nshakira, Nathan
    There is scarcity of information about the quality and safety of drinking water in Africa. Without such vital information, sustainable development goal number 6 which promotes availability and sustainable management of water and sanitation remains elusive especially in developing countries. The study aimed at determining concentrations of inorganic compounds, estimated daily intake (EDI), target hazard quotient (THQ), hazard index (HI), incremental lifetime cancer risk (ILCR), and identify safe drinking water source sources in Southwestern Uganda. Methods. This was an observational study in which 40 drinking water samples were collected from georeferenced boreholes, springs, open wells, bottled, and taps within Bushenyi district of Southwestern Uganda. Water samples were analyzed for copper (Cu), iron (Fe), zinc (Zn), lead (Pb), cadmium (Cd), and chromium (Cr) levels using atomic absorption spectrometry (AAS). Water safety measures (EDI, HI, and ILCR) were established for each water source and compared with local and international water permissible standards for each analyte. A spatial map was drawn using qGIS®, and analysis of quantitative data was done using MS Excel 2013 at 95% significance. Results. Heavy metals were present in the following order: 11.276 ppm > 4.4623 ppm > 0.81 ppm > 0.612 ppm > 0.161 ppm for Fe, Zn, Pb, Cu, and Cd, respectively, while Cr was not detected. Fe was the primary water heavy metal in the order of open well > borehole > tap > spring > bottled water. This was followed by Zn levels in the order of tap > bottled > spring > borehole > open well. All compounds were within international water safety standards except Pb. Hence, there is need for the government of Uganda to establish water filtration systems, particularly for Pb to improve the quality of water for the general public. The EDI was similar () for water consumed from spring, bottled, and tap sources for Fe and Zn levels. Similarly, no differences were found in the EDI for children and adults . Furthermore, the HI showed an absence of noncarcinogenic risk associated (HI < 1), although the ILCR was higher in adults than children due to high Cd concentrations. The current identified Fe is a major heavy metal in drinking water of Uganda, and boreholes were the major safest sources of drinking water identified in this study.