Browsing by Author "Orach, Christopher Garimoi"

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    Ethnicity, Gender, and Migration Status: Applying intersectionality Methodology to Explore Barriers to Equitable Health Systems for Maternal and Newborn Health among Immigrant Populations in Masindi, Uganda
    (Medicine, 2022) Ayiasi, Richard Mangwi; Mangwi, Alice Jean Ochola; Young, Ruth; Orach, Christopher Garimoi; Morgan, Rosemary
    Globally, 298,000 women die due to pregnancy related causes and half of this occurs in Africa. In Uganda, maternal mortality has marginally reduced from 526 to 336 per 100,000 live births between 2001 and 2016. Health facility delivery is an important factor in improving maternal and neonatal outcomes. However, the concept of using a skilled birth attendant is not popular in Uganda. An earlier intervention to mobilize communities in the Masindi region for maternal and newborn health services discovered that immigrant populations used maternal health services less compared to the indigenous populations. The aim of this qualitative study was therefore to better understand why immigrant populations were using maternal health services less and what the barriers were in order to suggest interventions that can foster equitable access to maternal health services. Five focus group discussions (FGDs) (three among women; 2 with men), 8 in-depth interviews with women, and 7 key informant interviews with health workers were used to better understand the experiences of immigrants with maternal and newborn services. Interviews and FGDs were conducted from July to September 2016. Data were analyzed using content analysis and intersectionality. Results were based on the following thematic areas: perceived discrimination based on ethnicity as a barrier to access, income, education and gender. Immigrant populations perceived they were discriminated against because they could not communicate in the local dialect, they were poor casual laborers, and/or were not well schooled. Matters of pregnancy and childbearing were considered to be matters for women only, while financial and other decisions at the households are a monopoly of men. The silent endurance of labor pains was considered a heroic action. In contrast, care-seeking early during the onset of labor pains attracted ridicule and was considered frivolous. In this context, perceived discrimination, conflicting gender roles, and societal rewards for silent endurance of labor pains intersect to create a unique state of vulnerability, causing a barrier to access to maternal and newborn care among immigrant women. We recommend platforms to demystify harmful cultural norms and training of health workers on respectful treatment based on the 12 steps to safe and respectful mother baby-family care.
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    Factors associated with family planning use among refugee and host populations in Adjumani district, West Nile, Uganda: a comparative study
    (BioMed Central Ltd, 2024-03-11) Achola, Roselline; Atuyambe, Lynn; Nabiwemba, Elizabeth; Fredrick, Makumbi; Orach, Christopher Garimoi
    Uganda currently hosts an estimated 1.5 million refugees. The refugees have challenges in accessing family planning (FP) services in the host country. The study aimed to investigate factors associated with FP use among host and refugee populations in Adjumani district, Uganda. A comparative cross-sectional study was conducted in May 2021 in three refugee settlements and their host communities in Adjumani district. A total of 1,310 respondents, (664 refugees and 646 host) were randomly selected using multistage cluster sampling and interviewed. Quantitative data were collected using structured questionnaires and analyzed using STATA V.15. Descriptive and Multivariate analysis performed. We found that modern Contraceptive Prevalence Rate (mCPR) was 30.2% (32.2% for host and 28.2% for refugees). Multivariate analysis showed that women who live singly (AOR = 2.25, 95%, CI: 1.56 -3.84), completed primary education [AOR = 1.65, 95% CI: 1.27-2.16], acquired skills [AOR = 2.28, 95% CI: 2.11-2.47], have the desire for another child [AOR = 3.73, 95% CI: 1.45- 9.60], have stayed in the study area between 3-5 years [AOR = 2.24, 95% CI: 1.46-3.42] were statistically significantly associated with FP use among both refugee and host populations. The key barrier to FP use by host was harassment of women and separation/divorce for not consulting the family members. Whereas amongst the refugees, they do not want to use FP methods. Our findings revealed low FP use amongst both populations in Adjumani district. The main factors associated with FP use amongst refugee populations included marital status, level of education, type of occupation, and duration of stay in the study area whereas amongst the host is the marital status. Main reasons for not using FP methods included fear of side effects by hosts and not wanting to use FP by refugees. There is need to sensitize both communities about the benefits of FP at community level.
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    Sanitation facilities in Kampala slums, Uganda: users' satisfaction and determinant factors
    (International Journal of Environmental Health Research, 2013) Tumwebaze, Innocent Kamara; Orach, Christopher Garimoi; Niwagaba, Charles; Luthi, Christoph; Mosler, Hans-Joachim
    Access to improved sanitation is a key preventive measure against sanitaryrelated gastro-enteric diseases such as diarrhoea. We assessed the access to facilities and users’ satisfaction in 50 randomly selected slums of Kampala through a cross-sectional survey conducted in 2010. A total of 1500 household respondents were interviewed. Sixty-eight per cent of the respondents used shared toilets, 20% private, 11% public toilets and less than 1% reported using flying toilets or practising open defecation. More than half of the respondents (51.7%) were not satisfied with their sanitation facilities. Determinants for satisfaction with the facilities used included the nature and type of toilet facilities used, their cleanliness, and the number of families sharing them. The study findings showed that slum dwellers had high access to sanitation facilities. However, most of them were shared and majority of the respondents were not satisfied with their facilities, primarily due to cleanliness and over demand.