Browsing by Author "Sserwanja, Quraish"
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Item Anemia and Associated Factors Among Lactating Women in Sierra Leone: An Analysis of the Sierra Leone Demographic and Health Survey 2019(Nutrition and Metabolic Insights, 2019) Arinda, Ivan Kato; Sserwanja, Quraish; Kamara, Kassim; Mukunya, David; Napyo, Agnes; Nsubuga, Edirisa Juniour; Nuwahereza, Christinah; Kagali, Anitah; Seungwon, LeeAnemia is a condition in which hemoglobin (Hb) concentration and/or red blood cell (RBC) numbers are lower than normal and insufficient to meet an individual’s physiological needs. The prevalence of anemia among women of reproductive age is high in Sub-Saharan Africa (SSA), including Sierra Leone. However, data on anemia among lactating women in Sierra Leone are scarce. Therefore, this study was conducted to estimate the prevalence of anemia and determine its associated factors among lactating women in Sierra Leone.The 2019 Sierra Leone Demographic and Health Survey (SLDH) data were used of which 1543 lactating women aged 15 to 49 years old had hemoglobin measurements. Multistage stratified sampling was used to select study participants and data were collected using validated questionnaires. Multivariate binary logistic regression was used to determine factors associated with anemia among lactating women in Sierra Leone.The general prevalence of anemia among lactating women in Sierra Leone was 52.9% (95% CI = 50.9-55.8). Almost a quarter, 23.8% (95% CI = 22.1-26.3) of the lactating women had mild anemia, 27.4% (95% CI = 25.3-29.7) had moderate anemia and 1.7% (95% CI = 1.1-2.5) had severe anemia. The use of modern contraceptives (aOR = 1.64, 95% CI = 1.09-2.47), not being visited by a field worker in the past year (aOR = 1.51, 95% CI = 1.12-2.03) and being Muslim (aOR = 1.46, 95% CI = 1.11-1.91), were associated with higher odds of being anemic. Being given and having bought iron supplements during pregnancy (aOR = 0.46, 95% CI = 0.25-0.87) was associated with less odds of being anemic.More than half of the lactating mothers in our study were anemic. The risk factors for anemia in our study included: use of modern contraceptives, not being visited by a field worker in the past year and being Muslim. Receiving iron supplements during pregnancy was protective against anemia. According to the results from this study, the recommendation for lactating women was to maintain routine interface with the healthcare system which includes being visited by a field worker who should prescribe and issue iron supplements to them. Lactating women especially Muslims should receive routine nutrition education by the health workers at the health facilities during antenatal care visits or postnatal care in regard to anemia and means of prevention and treatment. Community stakeholders should also work in collaboration to establish scalable methods to correctly identify pregnant women with risk factors, inform them about anemia with caution, and apply appropriate measures as trained or instructedItem Association between exposure to family planning messages on different mass media channels and the utilization of modern contraceptives among young women in Sierra Leone: insights from the 2019 Sierra Leone Demographic Health Survey(BMC Women's Health, 2022-09-16) Sserwanja, Quraish; Turimumahoro, Patricia; Nuwabaine, Lilian; Kamara, Kassim; Musaba, Milton W.Access to sexual and reproductive health information enables young women to make appropriate decisions. We examined the association between exposure to family panning messages on different mass media and the use of modern contraceptives among young women in Sierra Leone. This was a secondary analysis of the 2019 Sierra Leone Demographic and Health Survey data of young women aged 15–24 years. Multistage stratified sampling was used to select study participants in the survey. We used multivariable logistic regression to determine the association between exposure to family panning messages on different types mass media channels and utilization of modern contraceptives. All our analyses were done using SPSS version 25. Out of 6055 young women, 1506 (24.9%, 95% CI 24.0–26.2) were utilizing a modern contraceptive method with the prevalence higher among urban women (26.5%) compared to rural women (23.1%). Less than half (45.6%) had been exposed to family planning messages on mass media (radio 28.6%, television 10.6%, mobile phones 4.2% and newspapers or magazines 2.2%). Young women who had exposure to family planning messages on radio (AOR: 1.26, 95% CI 1.06–1.50) and mobile phones (AOR: 1.84, 95% CI 1.25–2.69) had higher odds of using modern contraceptives compared to their counterparts without the same exposure. Furthermore, having access to internet (AOR: 1.45, 95% CI 1.19–1.78), working (AOR: 1.49, 95% CI 1.27–1.74), being older (20–24 years) (AOR: 1.75, 95% CI 1.46–2.10), being married (AOR: 0.33, 95% CI 0.26–0.42), having visited a health facility within the last 12 months (AOR: 1.34, 95% CI 1.10–1.63), having secondary (AOR: 2.83, 95% CI 2.20–3.64) and tertiary levels of education (AOR: 3.35, 95% CI 1.83–6.13), higher parity (having above one child) AOR: 1.57, 95% CI 1.19–2.08) and residing in the southern (AOR: 2.11, 95% CI 1.61–2.79), northwestern (AOR: 1.87, 95% CI 1.39–2.52), northern (AOR: 2.11, 95% CI 1.59–2.82) and eastern (AOR: 1.68, 95% CI 1.27–2.22) regions of residence were associated with higher odds of modern contraceptives utilization. In Sierra Leon, only one in four young women were using modern contraception and more than half of them had not had any exposure to family planning messages on the different types of mass media channels. Behavior change communicators can prioritize family planning messages using radio, mobile phones and the internet. In order to publicize and encourage young women to adopt healthy behaviours and increase uptake of modern contraceptive.Item Continuum of maternal and newborn health in Sierra Leone: a 2019 national survey(Archives of Public Health, 2022-08-09) Sserwanja, Quraish; Nuwabaine, Lilian; Mutebi, Ronald K.; Musaba, Milton W.Globally, Sierra Leone has some of the worst maternal and child health indicators. The situation is worsened by a dearth of evidence about the level of continuum of care, an evidence-based intervention aimed at reducing maternal and perinatal morbidity and mortality. Hence this study aimed to assess the level of and factors associated with continuum of maternal and newborn care in Sierra Leone.Item Determinants of quality contraceptive counselling information among young women in Sierra Leone: insights from the 2019 Sierra Leone demographic health survey(BMC Women's Health, 2023-05-15) Sserwanja, Quraish; Nuwabaine, Lilian; Kamara, Kassim; Musaba, Milton W.The quality of contraceptive counseling information received by prospective clients of family planning services can greatly influence both the uptake and continued use of contraceptives. Therefore, an understanding of the level and determinants of quality contraception information among young women in Sierra Leon could inform family programs, with the aim of reducing the high unmet need in the country.Item Factors associated with health facility utilization during childbirth among 15 to 49-year-old women in Uganda: evidence from the Uganda demographic health survey 2016(BMC Health Services Research, 2021) Sserwanja, Quraish; Mukunya, David; Musaba, Milton W.; Kawuki, Joseph; Kitutu, Freddy EricAlmost all maternal deaths and related morbidities occur in low-income countries. Childbirth supervised by a skilled provider in a health facility is a key intervention to prevent maternal and perinatal morbidity and mortality. Our study aimed to establish the factors associated with health facility utilization during childbirth in Uganda. Methods: We used the Uganda Demographic and Health Survey 2016 data of 10,152 women aged 15 to 49years. The study focused on their most recent live birth in 5 years preceding the survey. We applied multistage stratified sampling to select study participants and we conducted multivariable logistic regression to establish the factors associated with health facility utilization during childbirth, using SPSS (version 25). Results: The proportion of women who gave birth at a health facility was 76.6% (7780/10,152: (95% confidence interval, CI, 75.8–77.5). The odds of women aged 15–19years giving birth at health facilities were twice as those of women aged 40 to 49years (adjusted odds ratio, AOR=2.29; 95% CI: 1.71–3.07). Residing in urban areas and attending antenatal care (ANC) were associated with health facility use. The odds of women in the northern region of Uganda using health facilities were three times of those of women in the central region (AOR=3.13; 95% CI: 2.15–4.56). Women with tertiary education (AOR=4.96; 95% CI: 2.71–9.11) and those in the richest wealth quintile (AOR=4.55; 95% CI: 3.27–6.32) had higher odds of using a health facility during child birth as compared to those with no education and those in the poorest wealth quintile, respectively. Muslims, Baganda, women exposed to mass media and having no problem with distance to health facility had higher odds of utilizing health facilities during childbirth as compared to Catholic, non Baganda, women not exposed to mass media and those having challenges with distance to access healthcare. Conclusion: Health facility utilization during childbirth was high and it was associated with decreasing age, increasing level of education and wealth index, urban residence, Northern region of Uganda, ANC attendance, exposure to mass media, tribe, religion and distance to the nearby health facility. We recommend that interventions to promote health facility childbirths in Uganda target the poor, less educated, and older women especially those residing in rural areas with less exposure to mass media.Item Factors Associated with HIV Testing among Pregnant Women in Rwanda: A Nationwide Cross-Sectional Survey(PLOS Global Public Health, 2024-01-18) Nuwabaine, Lilian; Kawuki, Joseph; Namulema, Angella; Asiimwe, John Baptist; Sserwanja, Quraish; Gatasi, Ghislaine; Donkor, ElormHuman immunodeficiency virus (HIV) testing during pregnancy is crucial for the prevention of mother-to-child transmission of HIV, through aiding prompt treatment, care, and support. However, few studies have explored HIV testing among pregnant women in Rwanda. This study, therefore, aimed to determine the prevalence and associated factors of HIV testing among pregnant women in Rwanda. We used secondary data from the 2020 Rwanda Demographic and Health Survey (RDHS), comprising 870 pregnant women. Multistage stratified sampling was used by the RDHS team to select participants. We conducted bivariable and multivariable logistic regression to explore factors associated with HIV testing using SPSS (version 25). Of the 870 pregnant women, 94.0% had tested for HIV during their current pregnancy. Younger age (24–34 years), not working, large household size, multiple sex partners, as well as secondary, primary, and no education were associated with higher odds of HIV testing compared to their respective counterparts. However, being unmarried, belonging to the western region, having not visited a health facility, and not having comprehensive HIV knowledge were associated with lower odds of HIV testing. A high proportion of pregnant women had tested for HIV. The study revealed that individual-level factors had the greatest influence on HIV testing in pregnancy, with a few household-level factors showing significance. There is a need for maternal health stakeholders to design and develop HIV testing programs that are region-sensitive. These programs should target older, more educated, working, and unmarried women with limited HIV knowledge.Item Factors Associated with Over-Nutrition Among Men 15-54years in Uganda: A National Survey(Nutrition and Metabolic Insights, 2021) Arinda, Ivan Kato; Sserwanja, Quraish; Nansubuga, Sylvia; Mukunya, David; Akampereza, PhionaGlobally and in Sub-Saharan Africa (SSA), the prevalence of overweight and obesity are on the rise. Data on overweight and obesity among men are scarce.We aimed to determine the prevalence and factors associated with over-nutrition among men in Uganda.We used Uganda Demographic and Health Survey (UDHS) 2016 data of 5,408 men aged 15 to 45 years. Multistage stratified sampling was used to select study participants and data were collected using validated questionnaires. Multivariable logistic regression was used to determine factors associated with over-nutrition among 15 to 54-year-old men in Uganda.The prevalence of over nutrition was 9.1%, where that of overweight was 7.9% (95% CI 7.2-8.7 and obesity was1.2% (95% CI 0.9-1.5). Men who were aged 25 to 34 (AOR = 3.28; 95% CI: 1.92-5.59), 35-44 (AOR = 4.51; 95% CI: 2.61-7.82) and 45 to 54 (AOR = 4.28; 95% CI: 2.37-7.74) were more likely to have over-nutrition compared to those aged 15 to 24 years. Married men (AOR=2.44; 95% CI: 1.49-3.99) were 2 times more likely to have over-nutrition than men who were not married. Men in the central region (AOR = 1.78; 95% CI: 1.22-2.60) were 1.78 times more likely to have over-nutrition than men in the northern region. Men who were in the richest wealth index quintiles were 10 times more likely to have over-nutrition compared to those in the poorest wealth index quintile (AOR = 9.38: 95 % CI 5.14-17.10).The factors associated with over-nutrition among Ugandan men in our study were increasing age, marital status, increasing wealth and region of origin. This shows the need for measures to abate the regional development inequalities, need to promote physical activity among older men and need to improve on the knowledge of nutrition and dietetic practices for married couples and men of different social classes.Item Factors associated with prolonged hospitalization of patients with corona virus disease (COVID‑19) in Uganda: a retrospective cohort study(Tropical Medicine and Health, 2022) Ingabire, Prossie M.; Nantale, Ritah; Sserwanja, Quraish; Nakireka, Susan; Musaba, Milton W.; Muyinda, Asad; Tumuhaise, Criscent; Namulema, Edith; Bongomin, Felix; Napyo, Agnes; Ainembabazi, Rozen; Olum, Ronald; Munabi, Ian; Kiguli, Sarah; Mukunya, DavidIdentification of factors predicting prolonged hospitalization of patients with coronavirus disease (COVID-19) guides the planning, care and flow of patients in the COVID-19 Treatment Units (CTUs). We determined the length of hospital stay and factors associated with prolonged hospitalization among patients with COVID-19 at six CTUs in Uganda. Methods: We conducted a retrospective cohort study of patients admitted with COVID-19 between January and December 2021 in six CTUs in Uganda. We conducted generalized linear regression models of the binomial family with a log link and robust variance estimation to estimate risk ratios of selected exposure variables and prolonged hospitalization (defined as a hospital stay for 14 days or more). We also conducted negative binomial regression models with robust variance to estimate the rate ratios between selected exposures and hospitalization duration. Results: Data from 968 participants were analyzed. The median length of hospitalization was 5 (range: 1–89) days. A total of 136/968 (14.1%: 95% confidence interval (CI): 11.9–16.4%) patients had prolonged hospitalization. Hospitalization in a public facility (adjusted risk ratio (ARR) = 2.49, 95% CI: 1.65–3.76), critical COVID-19 severity scores (ARR = 3.24: 95% CI: 1.01–10.42), and malaria co-infection (adjusted incident rate ratio (AIRR) = 0.67: 95% CI: 0.55–0.83) were associated with prolonged hospitalization. Conclusion: One out of seven COVID-19 patients had prolonged hospitalization. Healthcare providers in public health facilities should watch out for unnecessary hospitalization. We encourage screening for possible co-morbidities such as malaria among patients admitted for COVID-19.Item Factors Associated with Quality of Intrapartum Care in Kenya: a Complex Samples Analysis of the 2022 Kenya Demographic and Health Survey(ResearchSquare, 2024-02-02) Nuwabaine, Lilian; Amwiine, Earnest; Sserwanja, Quraish; Kawuki,Joseph; Amperiize, Mathius; Namulema, Angella; Asiimwe, John BaptistQuality of intrapartum care remains a key intervention for increasing women’s utilization of skilled birth attendants in health facilities and improving maternal and newborn health. This study aimed to investigate the factors associated with the quality of intrapartum care using the 2022 Kenya Demographic and Health Survey (KDHS). Secondary data from the 2022 KDHS of 11,863 participants, who were selected by multistage stratied sampling, was used. Quality of intrapartum care was considered if a mother had a facility-based delivery, received skilled assistance during birth, and the baby immediately placed on the mother’s breast by skilled birth attendant within 1 hour after birth. We conducted multivariable logistic regression to determine the factors associated with quality of intrapartum care using SPSS (version 20).Item Factors Associated with Quality of Intrapartum Care in Kenya: a complex samples analysis of the 2022 Kenya demographic and health survey(Research Square, 2024) Nuwabaine, Lilian; Amwiine, Earnest; Sserwanja, Quraish; Namulema, Angella; Asiimwe, John BaptistQuality of intrapartum care remains a key intervention for increasing women’s utilization of skilled birth attendants in health facilities and improving maternal and newborn health. This study aimed to investigate the factors associated with the quality of intrapartum care using the 2022 Kenya Demographic and Health Survey (KDHS). Secondary data from the 2022 KDHS of 11,863 participants, who were selected by multistage stratied sampling, was used. Quality of intrapartum care was considered if a mother had a facility-based delivery, received skilled assistance during birth, and the baby immediately placed on the mother’s breast by skilled birth attendant within 1 hour after birth. We conducted multivariable logistic regression to determine the factors associated with quality of intrapartum care using SPSS (version 20). Of the 11,863 women who had recently given birth, about 52.6% had received quality intrapartum care. As part of the intrapartum care, 88.2% gave birth in a health facility, 90.4% obtained assistance from skilled birth attendants, and 59.8% had their babies placed on the breast by delivery assistants within 1 hour after birth. Women who had attained secondary education (aOR = 1.46, 95% CI: 1.23–1.90), were working (aOR 1.24, 95% CI: 1.00-1.53), had > = 3 living children (aOR = 1.31 ,95% CI: 1.02–1.68), took 31–60 minutes to reach the health facility (aOR = 1.49, 95% CI: 1.41–1.95), were assisted during child birth by doctors (aOR = 19.86, 95% CI: 2.89-136.43) and nurses/midwives/clinical ocers (aOR = 23.09, 95% CI: 3.36-158.89) had higher odds of receiving quality intrapartum care. On the other hand, women in the richest wealth index (aOR = 0.64, 95% CI: 0.42–0.98), those who gave birth through cesarean section (AOR = 0.27, 95% CI: 0.20–0.36) and those whose current age of their child was > = 2years (AOR = 0.76, 95% CI: 0.60–0.96) were less likely to receive quality intrapartum care. About half of the women received quality clinical intrapartum care in Kenya, with demographic characteristics seeming to be the main drivers of quality intrapartum care. There is need to empower women through increasing access to education and developing initiatives for their economic independence, as well as facilitating their increased access to skilled birth attendants to improve the quality of intrapartum care.Item Factors associated with utilization of quality antenatal care: a secondary data analysis of Rwandan Demographic Health Survey 2020(BMC health services research, 2022-06-22) Sserwanja, Quraish; Nuwabaine, Lilian; Gatasi, Ghislaine; Wandabwa, Julius N.; Musaba, Milton W.Over the last decade, progress in reducing maternal mortality in Rwanda has been slow, from 210 deaths per 100,000 live births in 2015 to 203 deaths per 100,000 live births in 2020. Access to quality antenatal care (ANC) can substantially reduce maternal and newborn mortality. Several studies have investigated factors that influence the use of ANC, but information on its quality is limited. Therefore, this study aimed to identify the determinants of quality antenatal care among pregnant women in Rwanda using a nationally representative sample.Item Over-nutrition and Associated Factors among 20 to 49- Year-old Women in Uganda: Evidence from the 2016 Uganda Demographic Health Survey(Pan African Medical Journal, 2021) Sserwanja, Quraish; Mukunya, David; Kawuki, Joseph; Mutisya, Linet Mueni; Musaba, Milton Wamboko; Arinda, Ivan Kato; Kagwisagye, Mathew; Ziaei, ShirinLow- and middle-income countries are currently faced with a double burden of malnutrition. There has, however, been little focus on research and interventions for women with over-nutrition. We aimed to determine the prevalence and factors associated with over-nutrition among 20 to 49-year-old women in Uganda.We used the Uganda demographic and health survey (UDHS) 2016 data of 4,640 women. We analysed data using SPSS (version 25), and we used multivariable logistic regression to determine factors associated with over-nutrition among 20 to 49-year-old women in Uganda.The prevalence of over-nutrition was 28.2% (95% confidence interval (CI): 26.8-29.4) with overweight at 19.3% and obesity at 8.9%. Women belonging to the poorer (adjusted odds ratio (AOR)=1.63; 95% CI: 1.17-2.28), middle (AOR=2.24; 95% CI: 1.61-3.13), richer (AOR=3.02; 95% CI: 2.14-4.25) and richest (AOR=6.35; 95% CI: 4.52-8.93) wealth index quintiles were more likely to be over-nourished compared to women in the poorest wealth index quintile. Married women (AOR=1.52; 95% CI: 1.26-1.83) were more likely to be over-nourished compared to non-married women. Older women were more likely to be over-nourished compared to younger women. Women in the Western (AOR=2.12; 95% CI: 1.66-2.71), Eastern (AOR=1.40; 95% CI: 1.04-1.88) and Central (AOR=2.25; 95% CI: 1.69-2.99) regions were more likely to be over-nourished compared to women in the Northern region.The design of multi-faceted over-nutrition reduction programs with an emphasis on older, married, financially stable women, and those living in the Western, Eastern and Central regions of the country is needed.Item Prevalence and factors associated with teenage pregnancy in Sierra Leone: evidence from a nationally representative Demographic and Health Survey of 2019(BMC Public Health, 2023-03-20) Nuwabaine, Lilian; Sserwanja, Quraish; Kamara, Kassim; Musaba, Milton W.Globally, teenage pregnancy remains a public health concern because of the associated maternal and perinatal morbidity and mortality. To address the extensive social, political and economic effects of teenage pregnancy, there is need for current epidemiological evidence on its prevalence and associated factors, especially from low resource settings where the burden is highest.Item Prevalence and factors associated with utilisation of postnatal care in Sierra Leone: a 2019 national survey(BMC public health, 2022-01-14) Sserwanja, Quraish; Nuwabaine, Lilian; Kamara, Kassim; Musaba, Milton W.Within Sub-Saharan Africa, some countries still report unacceptably high rates of maternal and perinatal morbidity and mortality, despite improvements in the utilisation of maternity care services. Postnatal care (PNC) is one of the recommended packages in the continuum of maternity care aimed at reducing maternal and neonatal mortality. This study aimed to determine the prevalence and factors associated with PNC utilisation in Sierra Leone.Item Prevalence of Risk Factors for Human Immunodeficiency Virus among Sexually active Women in Rwanda: a nationwide survey(BMC Public Health, 2023-11-10) Kawuki, Joseph; Nuwabaine, Lilian; Namulema, Angella; Asiimwe, John Baptist; Sserwanja, Quraish; Donkor,,ElormThe Human Immunodeficiency Virus (HIV) remains a global health burden, and despite the advancements in antiretroviral therapy and various strategies employed to curb HIV infections, the incidence of HIV remains disproportionately high among women. Therefore, this study aimed to determine the prevalence of the risk factors for the acquisition of HIV among sexually active women in Rwanda. Secondary data from the 2020 Rwanda Demographic Health Survey, comprising 10,684 sexually active women, was used. Multistage stratified sampling was employed to select the study participants. Multivariable logistic regression was conducted to determine the associated risk factors using the SPSS (version 25). Of the 10,684 sexually active women, 28.7% (95% confidence interval (CI): 27.5–29.4) had at least one risk factor for HIV acquisition. Having no education (AOR = 3.65, 95%CI: 2.16–6.16), being unmarried (AOR = 4.50, 95%CI: 2.47–8.21), being from female-headed households (AOR = 1.75, 95%CI: 1.42–2.15), not having health insurance (AOR = 1.34, 95%CI: 1.09–1.65), no HIV test history (AOR = 1.44, 95%CI: 1.01–2.08), being from the poorest wealth quintile (AOR = 1.61, 95%CI: 1.14–2.27) and lack of exposure to mass media (AOR = 1.30, 95%CI: 1.07–1.58) were associated with higher odds of exposure to at least one HIV acquisition risk factor. In contrast, age groups of 25–34 (AOR = 0.56, 95%CI: 0.44–0.71) and 35–44 years (AOR = 0.62, 95%CI: 0.48–0.80), rural residence (AOR = 0.63, 95%CI: 0.49– 0.81) and being from the western region (AOR = 0.67, 95%CI: 0.48–0.94) were associated with less odds of exposure to at least one HIV acquisition risk factor. More than a quarter of sexually active women in Rwanda had exposure to at least one risk factor for HIV acquisition. There is a need to maximize the use of mass media in disseminating HIV prevention and behavioral change messages. Engagement of religious leaders and promotion of HIV testing, especially among the never-testers, may be vital strategies in successful HIV prevention programs.Item Quality of Newborn Care and Associated Factors: An analysis of the 2022 Kenya Demographic and Health Survey(PLOS Global Public Health, 2024-11-13) Asiimwe, John Baptist; Amwiine, Earnest; Namulema, Angella; Sserwanja, Quraish; Namatovu, Imelda; Nuwabaine, LilianKenya one of the African countries has pledged to reduce neonatal death as per the 2030 World Health Organization target. Providing high-quality newborn care is critical in minimizing neonatal mortality. This study aimed to determine the factors that influence the quality of newborn care in Kenya. Secondary data from 11,863 participants of the 2022 Kenya Demographic and Health Survey (KDHS) were analyzed. The participants were chosen using two-stage stratified sampling. The quality of newborn care was operationalized as receiving all components of newborn care after childbirth, as reported by the mother. Using SPSS (version 29), univariate and multivariable logistic regression analyses were used to analyse the data. In this study, 32.7% (95% confidence interval [CI]: 31.0%-34.5%) of the mothers reported that their newborns had received all components of quality neonatal care after childbirth. Mothers who spent an average of one hour accessing the health facilities compared with those who spent less than half an hour were 1.33 (95%CI: 1.01–1.75) times more likely to report that their newborns had received quality newborn care. Mothers who gave birth in a non-government organization health facility were 30.37 (95%CI: 2.69–343.20) times more likely to report that their newborns had received quality newborn care compared with those who delivered from a faith-based organization. On the contrary, in terms of regions, mothers who lived in Nyanza, Eastern, and Rift Valley provinces compared with those who lived in the coastal regions were 0.53 (95%CI: 0.34–0.82), 0.61 (95%CI: 0.39–0.94), and 0.62 (95%CI: 0.41–0.93) times less likely to report that their newborns had received quality newborn care, respectively. Mothers who subscribed to other religions or faith (0.28 (95%CI: 0.10–0.76) compared with those from the Christian faith, were less likely to report that their newborns had received quality newborn care. Finally, mothers who gave birth through cesarean section were 0.44 (95%CI: 0.32–0.61) times less likely to report that their newborns had received quality newborn care than mothers who gave birth through spontaneous vaginal delivery. The study indicates that about a third of the neonates received quality newborn care and that facility-related and parental social factors were associated with receiving quality newborn care. Stakeholders need to pay more attention to newborn babies whose mothers come from certain regions of Kenya where the quality of newborn care was found to be low, minority religious faith denominations, and those who delivered by ceasearen section. Stakeholders also should focus on strengthening collaborations with NGO health facilities and achieving universal health coverage to improve the quality of newborn care provided in health facilities.Item Sexual Violence and Associated Factors among Women of Reproductive Age in Rwanda: a 2020 Nationwide Cross-sectional Survey(Archives of public health, 2023-06-19) Nuwabaine, Lilian; Kawuki, Joseph; Amwiine, Earnest; Asiimwe, John Baptist; Sserwanja, Quraish; Atwijukiire, HumphreySexual violence against women is a global public health issue with both short- and long-term effects on the physical and mental health of women. This study aimed to determine the prevalence of sexual violence and its associated factors among women of reproductive age in Rwanda. We used secondary data from the 2020 Rwanda Demographic and Health Survey of 1,700 participants, who were selected using multistage stratified sampling. Multivariable logistic regression was conducted to explore factors associated with sexual violence using SPSS (version 25). Of the 1,700 women of reproductive age, 12.4% (95%CI: 11.0–14.1) had experienced sexual violence. Justified beating (AOR = 1.34, 95%CI: 1.16–1.65), not having health insurance (AOR = 1.46, 95%CI: 1.26–2.40), not being involved in healthcare decision-making (AOR = 1.64, 95%CI: 1.99–2.70), having a husband/partner with primary (AOR = 1.70, 95%CI: 5.47–6.21) or no education (AOR = 1.84, 95%CI: 1.21–3.37), as well as having a husband/partner who sometimes (AOR = 3.37, 95%CI: 1.56–7.30) or often (AOR = 12.87, 95%CI: 5.64–29.38) gets drunk were positively associated with sexual violence. However, women from male-headed households (AOR = 0.52, 95%CI: 0.29–0.92) were less likely to experience sexual violence. There is a need to demystify negative culturally-rooted beliefs favouring sexual violence, such as justified beating, as well as increase efforts to promote women’s empowerment and healthcare access. Moreover, engaging men in anti-sexual violence strategies is paramount to addressing male-related issues that expose women to sexual violence.Item Survival analysis of patients with COVID‑19 admitted at six hospitals in Uganda in 2021: a cohort study(Archives of Public Health, 2022) Muyinda, Asad; Ingabire, Prossie M.; Nakireka, Susan; Tumuhaise, Criscent; Namulema, Edith; Bongomin, Felix; Napyo, Agnes; Sserwanja, Quraish; Ainembabazi, Rozen; Olum, Ronald; Nantale, Ritah; Akunguru, Phillip; Nomujuni, Derrick; Olwit, William; Musaba, Milton W.; Namubiru, Bridget; Aol, Pamela; Babigumira, Peter A.; Munabi, Ian; Kiguli, Sarah; Mukunya, DavidAssessing factors associated with mortality among COVID-19 patients could guide in developing context relevant interventions to mitigate the risk. The study aimed to describe mortality and associated factors among COVID-19 patients admitted at six health facilities in Uganda. Methods: We reviewed medical records of patients admitted with COVID-19 between January 1st 2021 and December 31st 2021 in six hospitals in Uganda. Using Stata version 17.0, Kaplan Meier and Cox regression analyses were performed to describe the time to death and estimate associations between various exposures and time to death. Finally, accelerated failure time (AFT) models with a lognormal distribution were used to estimate corresponding survival time ratios. Results: Out of the 1040 study participants, 234 (22.5%: 95%CI 12.9 to 36.2%) died. The mortality rate was 30.7 deaths per 1000 person days, 95% CI (26.9 to 35.0). The median survival time was 33 days, IQR (9–82). Factors associated with time to COVID-19 death included; age ≥ 60 years [adjusted hazard ratio (aHR) = 2.4, 95% CI: [1.7, 3.4]], having malaria test at admission [aHR = 2.0, 95% CI:[1.0, 3.9]], a COVID-19 severity score of severe/critical [aHR = 6.7, 95% CI:[1.5, 29.1]] and admission to a public hospital [aHR = 0.4, 95% CI:[0.3, 0.6]]. The survival time of patients aged 60 years or more is estimated to be 63% shorter than that of patients aged less than 60 years [adjusted time ratio (aTR) 0.37, 95% CI 0.24, 0.56]. The survival time of patients admitted in public hospitals was 2.5 times that of patients admitted in private hospitals [aTR 2.5 to 95%CI 1.6, 3.9]. Finally, patients with a severe or critical COVID-19 severity score had 87% shorter survival time than those with a mild score [aTR 0.13, 95% CI 0.03, 0.56]. Conclusion: In-hospital mortality among COVID-19 patients was high. Factors associated with shorter survival; age ≥ 60 years, a COVID-19 severity score of severe or critical, and having malaria at admission. We therefore recommend close monitoring of COVID-19 patients that are elderly and also screening for malaria in COVID-19 admitted patients.Item Trends and determinants of modern contraceptive utilisation among adolescent girls aged 15-19 years in Sierra Leone: an analysis of Demographic and Health Surveys, 2008-2019(Journal of Global Health Reports, 2023-06-04) Olal , Emmanuel; Grovogui, Fassou Mathias; Nantale, Ritah; Sserwanja, Quraish; Nakazwe, CholaModern contraceptives are effective interventions for preventing unwanted pregnancies, but their use remain low among adolescent girls in sub-Saharan Africa. First, we aimed to assess the trends of modern contraceptive use among adolescent girls aged 15-19 years in Sierra Leone in the period 2008-2019. Second, we explored how individual and contextual determinants of their use changed during this period. We used a combined sample of 8,774 adolescent girls aged 15-19 years from the 2008, 2013, and 2019 Sierra Leone Demographic and Health Surveys (SLDHS), respectively, to estimate the modern contraceptive prevalence rate (MCPR) and unmet need for family planning. We described the method mix and sources of contraceptives among modern method users. We then conducted a multivariable logistic regression to examine the determinants of modern contraceptive use among sexually active adolescent girls, separately for 2008 and 2019. MCPR increased from 5.9% (95% CI=4.5-7.8) in 2008 to 21.0% (95% CI=19.2-22.9) in 2019. Most of the increase had occurred by 2013. Norplant (48.8%) and injectables (39%) were the common methods in 2019. Unmet need for family planning declined from 15.4% (95% CI=13.2-17.9) in 2008 to 11.3% (95% CI=9.9-12.7) in 2019, while the prevalence of modern contraceptive use among sexually active adolescent girls increased from 13.1% (95% CI=10-17.0) in 2008 to 43.5% (95% CI=40.2-46.9) in 2019. In both the 2008 and 2019 surveys, the adjusted odds of using modern contraceptives among sexually active adolescent girls were higher among those with more than one sexual partner in the past 12 months, and with secondary or tertiary education. In 2019, the adjusted odds of using a modern contraceptive were also lower among adolescent girls who were married or living with a partner, had more than one child, and lived in the Western province. The increase in contraceptive use among adolescent girls in Sierra Leone had stalled since 2013. Interventions, including increasing awareness and accessibility to modern contraceptives, are urgently needed, particularly for adolescents without formal education. Comprehensive and affordable community and school-based interventions, including adolescent-friendly services, would be helpful.