Browsing by Author "Tuhebwe, Doreen"

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    “The burden is upon your shoulders to feed and take care of your children, not religion or culture”: qualitative evaluation of participatory community dialogues to promote family planning’s holistic benefits and reshape community norms on family success in rural Uganda
    (BioMed Central, 2024-05) Sileo, Katelyn M.; Muhumuza, Christine; Tuhebwe, Doreen; Muñoz, Suyapa; Wanyenze, Rhoda K.; Kershaw, Trace S; Sekamatte, Samuel; Lule, Haruna; Kiene, Susan M.
    Background Family planning has significant health and social benefits, but in settings like Uganda, is underutilized due to prevalent community and religious norms promoting large family size and gender inequity. Family Health = Family Wealth (FH = FW) is a multi-level, community-based intervention that used community dialogues grounded in Campbell and Cornish’s social psychological theory of transformative communication to reshape individual endorsement of community norms that negatively affect gender equitable reproductive decision-making among couples in rural Uganda. Methods This study aimed to qualitatively evaluate the effect of FH = FW’s community dialogue approach on participants’ personal endorsement of community norms counter to family planning acceptance and gender equity. A pilot quasi-experimental controlled trial was implemented in 2021. This paper uses qualitative, post-intervention data collected from intervention arm participants (N = 70) at two time points: 3 weeks post-intervention (in-depth interviews, n = 64) and after 10-months follow-up (focus group discussions [n = 39] or semi-structured interviews [n = 27]). Data were analyzed through thematic analysis. Results The community dialogue approach helped couples to reassess community beliefs that reinforce gender inequity and disapproval of family planning. FH = FW’s inclusion of economic and relationship content served as key entry points for couples to discuss family planning. Results are presented in five central themes: (1) Community family size expectations were reconsidered through discussions on economic factors; (2) Showcasing how relationship health and gender equity are central to economic health influenced men’s acceptance of gender equity; (3) Linking relationship health and family planning helped increase positive attitudes towards family planning and the perceived importance of shared household decision-making to family wellness; (4) Program elements to strengthen relationship skills helped to translate gender equitable attitudes into changes in relationship dynamics and to facilitate equitable family planning communication; (5) FH = FW participation increased couples’ collective family planning (and overall health) decision-making and uptake of contraceptive methods. Conclusion Community dialogues may be an effective intervention approach to change individual endorsement of widespread community norms that reduce family planning acceptance. Future work should continue to explore innovative ways to use this approach to increase gender equitable reproductive decision-making among couples in settings where gender, religious, and community norms limit reproductive autonomy. Future evaluations of this work should aim to examine change in norms at the community-level.
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    Factors associated with willingness to take up indoor residual spraying to prevent malaria in Tororo district, Uganda: a cross‑sectional study
    (Malaria Journal, 2018) Wadunde, Ignatius; Mpimbaza, Arthur; Musoke, David; Ssempebwa, John C.; Ediau, Michael; Tuhebwe, Doreen; Adoke, Yeka; Wanyenze, Rhoda K.
    take up IRS is critical to its success. The first phase of IRS was conducted in Tororo district, Uganda between December 2014 and January 2015. High coverage rates (90%) were attained in the district. However, Mulanda sub-county had the lowest coverage of 78%, in the first round. This study assessed willingness and associated factors of IRS uptake among household heads for the next IRS campaign in Mulanda sub-county, Tororo district. Methods: A household survey was conducted in all three parishes of Mulanda sub-county. A multistage sampling technique involving the village and household as the first and second sampling levels, respectively, was used to identify 640 households Household heads were interviewed using standard questionnaire. Seven key informants were also conducted to explore the impact of community IRS-perceptions on uptake. Bi-variable and multi-variable logistic regression analyses were used to identify factors associated with willingness to take up IRS. Qualitative data was analysed by thematic content analysis method. Results: Most (79.9%) respondents were willing to take up repeat IRS. However this was below the target of 85%. Fear of insecticide adverse effects (62%) was the most common reason mentioned by 134 (21%) household heads who were not willing to take up IRS. Factors associated with to take up IRS were; age ≥ 35 years (AOR 1.9; 95% CI 1.08–3.51), higher socio-economic status (AOR 0.4; 95% CI 0.27–0.98), not taking IRS in previous round (AOR 0.1; 95% CI 0.06–0.23), not knowing reason for conducting IRS (AOR 0.4; 95% CI 0.24–0.78) and having an iron sheet roof (AOR 2.2; 95% CI 1.03–4.73). Community and religious leaders were the preferred sources of IRS information.
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    Lowland Grazing And Marburg Virus Disease (MVD) Outbreak In Kween District, Eastern Uganda
    (BMC Public Health, 2019) Siya, Aggrey; Bazeyo, William; Tuhebwe, Doreen; Tumwine, Gabriel; Ezama, Arnold; Manirakiza, Leonard; Kugonza, Donald R.; Rwego, Innocent B.
    Uganda is one of the few countries in Africa that has been experiencing outbreaks of viral hemorrhagic fevers such as Ebola, Marburg and Crimean-Congo Hemorrhagic fevers. In 2017 Uganda experienced a Marburg Virus Disease (MVD) outbreak with case fatality rate of 100% in Kween district. Although hunting for wild meat was linked to the MVD outbreak in Kween district, less was reported on the land use changes, especially the changing animal grazing practices in Kween district.Through Makerere University One Health graduate fellowship program with attachment to Uganda Red Cross Society, a study was conducted among the agricultural communities to elucidate the risk behaviors in Kween district that can be linked to the 2017 Marburg disease outbreak.Results show that although a few elderly participants ascribed fatal causes (disobedience to gods, ancestors, and evil spirits) to the MVD outbreak during FGDs, majority of participants linked MVD to settling in caves (inhabited by Fruit Bats) during wet season as upper belts are extensively used for crop production leaving little space for animal grazing. Members also noted side activities like hunting for wild meat during this grazing period that could have predisposed them to Marburg Virus.There is need to integrate One Health concepts within agricultural extension service provision in Uganda so as to enhance the management of such infectious diseases.
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    Pneumonia among children under five in Uganda: symptom recognition and actions taken by caretakers
    (African health sciences, 2014) Tuhebwe, Doreen; Tumushabe, Elly; Leontsini, Elli; Wanyenze, Rhoda K.
    caretakers recognized the danger signs and sought appropriate treatment promptly. Methods: We interviewed 278 caretakers in Mukono district Uganda, whose under-five children had suffered from probable pneumonia two weeks prior to the evaluation. Through structured questionnaires we assessed caretaker’s knowledge about danger signs among under-five children with pneumonia and the actions taken to manage probable pneumonia using descriptive statistics. We also conducted in-depth interviews with caretakers and community health workers. Results: Lower chest wall in drawing (a pneumonia specific danger sign) was mentioned by only 9.4% of the caretakers. Among the Integrated Management of Childhood Illnesses (IMCI) standard general danger signs, inability to feed was the most commonly cited danger sign (37.8%) followed by incessant vomiting (10.1%). No caretaker mentioned all the four standard general danger signs. In terms of actions taken, most caretakers offered drinks (49.6%) and traditional herbs (45.3%) while, 31.7% gave antibiotics. Conclusions: Caretaker’s knowledge about danger signs was inadequate in relation to the IMCI guidelines. Caretakers used both modern and traditional forms of treatment to manage pneumonia. Comprehensive interventions geared at increasing symptom recognition and improving health-seeking behavior are needed to reverse this trend.