Browsing by Author "Rutaremwa, Gideon"

Now showing 1 - 9 of 9
  • Thumbnail Image
    Item
    Determinants of change in the inequality and associated predictors of teenage pregnancy in Uganda for the period 2006– 2016: analysis of the Uganda Demographic and Health Surveys
    (BMJ Open, 2021) Wasswa, Ronald; Kabagenyi, Allen; Muhumuza Kananura, Rornald; Jehopio, Joseph; Rutaremwa, Gideon
    Teenage pregnancy has become a public health concern in Uganda because of its negative consequences to both the mother and child. The objective of this study was to examine the determinants of change in the inequality and associated predictors of teenage pregnancy in Uganda for the period 2006– 2016. Study design A retrospective national cross-sectional study. Setting Uganda. Participants Uganda Demographic and Health Survey secondary data of only female teenagers aged 15–19 years. The samples selected for analyses were 1936 in 2006; 2048 in 2011 and 4264 in 2016. Outcome measure The primary outcome was teenage pregnancy. Analysis was performed using the logistic regression, equiplots, concentration curve, normalised concentration index, decomposition of the concentration index and Oaxaca-type decomposition. Results The prevalence of teenage pregnancy has seemingly remained high and almost constant from 2006 to 2016 with the risk worsening to the disadvantage of the poor. Household wealth-index, teenagers’ years of education, early sexual debut and child marriage were the main key predictors and contributors of the large inequality in teenage pregnancy from 2006 to 2016. Conclusion Teenage pregnancy is disproportionately prevalent among different subpopulations of adolescent girls in Uganda. We therefore recommend policy actions to sensitise communities and enforcement of child rights and child protection laws to stop child marriages. There is also need to promote girl child education, improving household incomes, and intensifying mass media awareness on the risks of early pregnancies. Further, ensuring that villages have operational adolescent and youth friendly services as well as incorporating sex education and other different adolescent reproductive health programmes in school curriculum will be key measures in reducing the large inequality in teenage pregnancy.
  • Thumbnail Image
    Item
    Determinants of change in the inequality and associated predictors of teenage pregnancy in Uganda for the period 2006– 2016: analysis of the Uganda Demographic and Health Surveys
    (British Medical Journal Publishing Group, 2021-11) Wasswa, Ronald; Kabagenyi, Allen; Kananura, Rornald Muhumuza; Jehopio, Joseph; Rutaremwa, Gideon
    Objective Teenage pregnancy has become a public health concern in Uganda because of its negative consequences to both the mother and child. The objective of this study was to examine the determinants of change in the inequality and associated predictors of teenage pregnancy in Uganda for the period 2006–2016.Study design A retrospective national cross-sectional study.Setting Uganda.Participants Uganda Demographic and Health Survey secondary data of only female teenagers aged 15–19 years. The samples selected for analyses were 1936 in 2006; 2048 in 2011 and 4264 in 2016.Outcome measure The primary outcome was teenage pregnancy. Analysis was performed using the logistic regression, equiplots, concentration curve, normalised concentration index, decomposition of the concentration index and Oaxaca-type decomposition.Results The prevalence of teenage pregnancy has seemingly remained high and almost constant from 2006 to 2016 with the risk worsening to the disadvantage of the poor. Household wealth-index, teenagers’ years of education, early sexual debut and child marriage were the main key predictors and contributors of the large inequality in teenage pregnancy from 2006 to 2016.Conclusion Teenage pregnancy is disproportionately prevalent among different subpopulations of adolescent girls in Uganda. We therefore recommend policy actions to sensitise communities and enforcement of child rights and child protection laws to stop child marriages. There is also need to promote girl child education, improving household incomes, and intensifying mass media awareness on the risks of early pregnancies. Further, ensuring that villages have operational adolescent and youth friendly services as well as incorporating sex education and other different adolescent reproductive health programmes in school curriculum will be key measures in reducing the large inequality in teenage pregnancy.
  • Thumbnail Image
    Item
    The Effect of Household Characteristics on Child Mortality in Uganda
    (American Journal of Sociological Research, 2013) Kabagenyi, Allen; Rutaremwa, Gideon
    The objective of this study was to establish the relationship between household characteristics and mortality among children under the ages of five in Uganda. Uganda in 2006experienced a high infant mortality rate of 76 deaths per 1000, far above the world’s average of 52 deaths /1000 live births. Of the infants that survive to the first birthday, 67 out of 1000 died before reaching their fifth birthday. In order to address this problem, the authors used survey data on 4,169 women respondents drawn from 14 districts of Uganda where the Uganda Ministry of Health intended to implement the Health Sector Strategic Plan II (2005/06 – 2009/10). Brass-type indirect techniques for mortality estimation were employed to establish the mortality rates. In addition, logistic regression analysis examined factors related with child mortality. Findings show wide mortality differentials by household type, place of residence, and household size. Mother’s education and children ever born were the two major variables highly associated with child mortality. The study concludes that household structure was not related to child mortality. There is need for adult literacy, secondary and above education for women and sensitization about the effects of large households and children ever born. Such studies provide insight into understanding the relationship between various household characteristics and child health outcomes.
  • Thumbnail Image
    Item
    Has Uganda experienced any stalled fertility transitions? Reflecting on the last four decades (1973–2011)
    (Fertility Research and Practice, 2015) Kabagenyi, Allen; Reid, Alice; Rutaremwa, Gideon; Atuyambe, Lynn M.; Ntozi, James P. M.
    Persistent high fertility is associated with mother and child mortality. While most regions in the world have experienced declines in fertility rates, there are conflicting views as to whether Uganda has entered a period of fertility transition. There are limited data available that explicitly detail the fertility trends and patterns in Uganda over the last four decades, from 1973 to 2011. Total fertility rate (TFR) is number of live births that a woman would have throughout her reproductive years if she were subject to the prevailing age specific fertility patterns. The current TFR for Uganda stands at 6.2 children born per woman, which is one of the highest in the region. This study therefore sought to examine whether there has been a fertility stall in Uganda using all existing Demographic Health Survey data, to provide estimates for the current fertility levels and trends in Uganda, and finally to examine the demographic and socioeconomic factors responsible for fertility levels in Uganda. This is a secondary analysis of data from five consecutive Ugandan Demographic Health Surveys (UDHS); 1988/1989, 1995, 2000/2001, 2006 and 2011. Using pooled data to estimate for fertility levels, patterns and trends, we applied a recently developed fertility estimation approach. A Poisson regression model was also used to analyze fertility differentials over the study period. Results: Over the studied period, fertility trends and levels fluctuated from highs of 8.8 to lows of 5.7, with no specific lag over the study period. These findings suggest Uganda is at the pre-transitional stage, with indications of imminent fertility rate reductions in forthcoming years. Marital status remained a strong predictor for number of children born, even after controlling for other variables. Conclusions: This study suggests there is no evidence of a fertility stall in Uganda, but demonstrates an onset of fertility transition in the country. If this trend continues, Uganda will experience a low fertility rate in the future—a finding pertinent for policy makers, especially as the continent and the country focus on harnessing the demographic dividend.
  • Thumbnail Image
    Item
    Low Contraceptive Use among Young Females in Uganda: Does Birth History and Age at Birth have an Influence? Analysis of 2011 Demographic and Health Survey
    (Journal of contraceptive studies, 2016) Kabagenyi, Allen; Habaasa, Gilbert; Rutaremwa, Gideon
    Globally adolescent fertility has been associated with increased risk to maternal and child health morbidity and mortality. The low use of contraception has been associated with high fertility levels, which is remains a public health concern that efforts have been raised to avert this. We examine the influence history of a previous birth and age at first birth would have on young women’s use of contraception. Methods—Using the 2011 Uganda Demographic and Health Survey data, we examine the predictors of contraceptive use on a sample of 3692 young females in Uganda. While controlling for education and age of respondents, logistic regression analyses were run to provide the net effect of the examined predictors on contraceptive use. The study variables included age of respondents, marital status, age at first birth, births in past five years, socioeconomic status, residence, region, education level, religion, occupation and whether the last child was wanted. Results—The findings show that only 12% of the adolescents were using contraception at the time of the survey. The key predictors of contraceptive use among young women in Uganda were age at first birth, history of previous birth, current age, and place of residence, education and socioeconomic status. Respondents who had a birth in the 5 years prior to the survey had five times (OR = 5.0, 95% CI = 3.7-6.5) the odds of contraceptive use compared to those who had never had a birth. Further, adolescent females with at least a secondary education were more likely to use contraceptives (OR = 1.55, 95% CI = 1.2-2.0) than those with primary education. The odds of contraceptive use were least among adolescents from Northern region (OR = 0.39, 95% CI = 0.2-0.6) compared to those from central region of Uganda. Muslim adolescent females were more likely to use contraceptives compared to Catholics (OR = 1.59, 95% CI = 1.1-2.3). Conclusion—There is great need to address issues that hinder young people from using contraception. Use of contraception and improving access to the services is highly recommended to avert some of the unplanned births among these females.
  • Thumbnail Image
    Item
    Perceived Partners’ Desire for More Children and Modern Contraceptive Use among Married Women in Uganda
    (Makerere University, 2011) Kabagenyi, Allen; Nankinga, Olivia; Rutaremwa, Gideon
    Globally, fertility levels have been gradually reducing and the current average fertility estimates present 1.7 births in developed countries, 4.1 in less developed countries and 4.8 in sub-Saharan Africa (UnitedNations 2011). Projections show that if Africa, fertility rates remain the same over the forth coming decades, the continent’s rapidly growing population is bound to reach 3 billion by 2050 and about 15 million by 2100 (Chamie 2011) . While rates are seemingly reducing, Uganda is one of the countries in Africa grappling with high fertility levels of over 6.2 children born per woman and a population growth rate of over 3.2 percent per annum (UBOS 2007; UBOS 2012). The country’s young age structure is attributed mainly to the persistent high fertility levels for the past decades and low contraceptive use. Universally an overwhelming 215 women in developing countries who would want to use contraceptives if availed to them however they lack access. Many women would want to use contraception to delay or limit births however they are not using anything as required. This exposes them to risk of having unwanted and unplanned pregnancies. It is no wonder that many women continue to die due to pregnancy related complications some of which could be averted with the use of contraception. Research has shown that in addition to development in socioeconomic status (Bongaarts, et al. 1984), contraceptive use had direct effects on fertility reductions in any given society(Ainsworth, et al. 1996; Caldwell and Caldwell 1990). Furthermore fertility scholars including Easterlin (1975), Cleland (2001) and Mason et al (2001), proposed other determinants that would help in the reduction of birth rates which include; improved child survival, increased education levels of mothers and rural-urban development (Ainsworth, et al. 1996; Bongaarts, et al. 1984; Collier and Gunning 1999). Though presented with an increment from a rate of 26 in 2006 to 30 in 2011 the current contraceptive prevalence based on the demographic health survey is still very low among married in Uganda UBOS & MACRO INT. (2012) , (Caldwell and Caldwell 2002; Collier and Gunning 1999). Given the different interventions in Uganda towards improvement and provision access to contraceptives and other methods of family planning, usage is still very low(Ntozi and 2 Kabera 1991; UBOS 2012) . This paper therefore seeks to show the influence of perceived partner’s desire for more children and it is on current contraceptive use among married women in Uganda.
  • Thumbnail Image
    Item
    Postpartum family planning utilization in Burundi and Rwanda: a comparative analysis of population based cross-sectional data
    (The Pan African Medical Journal, 2018) Rutaremwa, Gideon; Kabagenyi, Allen
    Promotion of modern family planning is a major policy action for Africa to harness the demographic dividend. Family planning is an important public health intervention for maternal and child health. Methods: Analysis was based on data from Demographic and Health Surveys conducted in 2010 on samples of women from Burundi (3396) and Rwanda (4670). Descriptive and multivariate logistic regression analyses to examine the contribution and comparison of the various predictors of uptake of modern contraceptives during the postpartum period (PPFP) in the two countries were carried out using STATA statistical software. Results: Descriptive findings show only 20% of the samples of women in Burundi used while more than half of the women (51%) were using PPFP. Utilization of PPFP was significantly associated with primary (OR = 1.3, 95% CI = 1.1-1.6) and higher education (OR = 2.2, 95% CI = 1.6-3.1) in Burundi. Similarly in Rwanda increased use of PPFP in primary was (OR = 1.4, 95% CI = 1.2-1.6) while secondary education (OR = 1.6, 95% CI = 1.2-2.1). Protestant women were less likely to use PPFP in both Burundi (OR = 0.75, 95% CI = 0.6-0.9) and Rwanda (OR = 0.69, 95% CI = 0.6-0.8). Other significant variables in the regression models of both countries included wealth status, age of woman, number of living children and exposure to media. Professional birth delivery assistance was significant only in Rwanda. Conclusion: Enhancing postpartum contraceptive use should target women with low education, low wealth status, and that the media has an important role to play in this transformation. Policies and programs must be put in place to ensure that the rural urban differences are eradicated.
  • Thumbnail Image
    Item
    Predictors of modern contraceptive use during the postpartum period among women in Uganda: a population-based cross sectional study
    (BMC public health, 2015) Rutaremwa, Gideon; Kabagenyi, Allen; Ojiambo Wandera, Stephen; Jhamba, Tapiwa; Akiror, Edith; Nviiri, Hellen Laetitia
    The rationale for promotion of family planning (FP) to delay conception after a recent birth is a best practice that can lead to optimal maternal and child health outcomes. Uptake of postpartum family planning (PPFP) remains low in sub-Saharan Africa. However, little is known about how pregnant women arrive at their decisions to adopt PPFP. Methods: We used 3298 women of reproductive ages 15–49 from the 2011 UDHS dataset, who had a birth in the 5 years preceding the survey. We then applied both descriptive analyses comprising Pearson’s chi-square test and later a binary logistic regression model to analyze the relative contribution of the various predictors of uptake of modern contraceptives during the postpartum period. Results: More than a quarter (28%) of the women used modern family planning during the postpartum period in Uganda. PPFP was significantly associated with primary or higher education (OR=1.96; 95% CI=1.43-2.68; OR=2.73; 95% CI=1.88-3.97 respectively); richest wealth status (OR=2.64; 95% CI=1.81-3.86); protestant religion (OR=1.27; 95% CI=1.05-1.54) and age of woman (OR=0.97, 95% CI=0.95-0.99). In addition, PPFP was associated with number of surviving children (OR=1.09; 95 % CI=1.03-1.16); exposure to media (OR=1.30; 95% CI=1.05-1.61); skilled birth attendance (OR=1.39; 95% CI=1.12-1.17); and 1–2 days timing of post-delivery care (OR=1.68; 95% CI=1.14-2.47). Conclusions: Increasing reproductive health education and information among postpartum women especially those who are disadvantaged, those with no education and the poor would significantly improve PPFP in Uganda.
  • Thumbnail Image
    Item
    Utilization of integrated HIV and sexual and reproductive health services among women in Uganda
    (BMC Health Services Research, 2016) Rutaremwa, Gideon; Kabagenyi, Allen
    While the rationale for integration of HIV and sexual and reproductive health (HIV and SRH) services is strong, there is paucity of information on which population groups most utilize these services. Such studies would inform policy and programs on integration of services. The overall objective of this assessment is to provide information to researchers, planners and policy makers on the best practices for integrated services in order to maximize feasibility of scaling up. Specifically, this research paper identifies demographic and socioeconomic factors that are most related to utilization of integrated services in Uganda. Methods: This manuscript uses data from a sample of 9,691 women interviewed during the Uganda AIDS Indicator Survey (UAIS) of 2011. The selection criteria of the study respondents for this paper included women of reproductive age 15 – 49 years. The dependent variable is whether the respondent utilized integrated HIV and SRH services during pregnancy and delivery of the last child, while independent variables include; region of residence, age-group of woman, marital status, rural-urban residence, wealth indicator and educational level attainment. In the main analysis, a binary logistic regression model was fitted to the data. Results: Log-odds of utilizing integrated services were significantly higher among those women with a primary education (OR = 1.2, 95 % CI = 1.0-1.4, p < 0.05) compared to those with no education. Women from the Central part of Uganda were more likely to utilize integrated HIV and SRH services (OR = 1.3, 95 % CI = 1.0-1.7, p < 0.05), further the log-odds of utilizing integrated HIV and SRH services were significantly higher among women residing in Northern region (OR = 1.6, 95 % CI = 1.2-2.2, p < 0.01). The odds of utilization of integrated HIV and SRH services were higher for currently married women (OR = 6.6, 95 % CI = 5.5-8.0, p < 0.01) and the formerly married (OR = 3.4, 95 % CI = 2.7-4.2, p < 0.01), compared to the never married group. The odds of utilizing integrated HIV and SRH services were higher for younger women of ages less than 35 years compared to older women aged 40 – 49 years. Conclusions: Utilization of integrated HIV and SRH services in Uganda is influenced greatly by demographic and socioeconomic characteristics. This study contributes to the current debate as it shows the on how best ways to improve HIV and SRH service delivery to the people.