Browsing by Author "Tumuhimbise, Wilson"

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    Challenges in Accessing Maternal and Child Health Services During COVID-19 and the Potential Role of Social Networking Technologies
    (Digital Health, 2022) Musiimenta, Angella; Tumuhimbise, Wilson; Atukunda, Esther C.; Ayebaza, Sandrah; Kobutungi, Phionah; Zender, Raphael; Haberer, Jessica E.
    The COVID-19 pandemic causes new challenges to women and their babies who still need to access postnatal care amidst the crisis. The novel application of social network technologies (SNTs) could potentially enhance access to healthcare during this difficult time. This study describes the challenges experienced in accessing maternal and child health services by women with limited or no education during this COVID-19 pandemic and discusses the potential of SNTs to support maternal and child health amidst this crisis. We administered surveys to women who had recently given birth in a rural setting and interviewed a purposively selected subset to ascertain their experiences of accessing maternal and child health services during the COVID-19 pandemic. Our analysis involved descriptive analysis of quantitative data using STATA 13 to describe study participants’ characteristics, and content analysis of qualitative data to derive categories describing maternal health challenges. Among 50 women, the median age was 28 years (interquartile range 24–34), 42 (84%) completed upper primary education. Access to the health facility was constrained by transport challenges, fear of contracting COVID-19, and delays at the facility. Due to the COVID-19 crisis, 42 (84%) women missed facility visits, 46 (92%) experienced financial distress, 43 (86%) had food insecurity, and 44 (88%) felt stressed. SNTs can facilitate remote and timely access to health services and information, and enable virtual social connections and support. SNTs have the potential to mitigate the challenges faced in accessing maternal and child health services amidst the ongoing COVID-19 pandemic.
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    Enhancing the implementation and integration of mHealth interventions in resource-limited settings: a scoping review
    (BioMed Central Ltd, 2024-10) Tumuhimbise, Wilson; Theuring, Stefanie; Kaggwa, Fred; Atukunda, Esther C; Rubaihayo, John; Atwine, Daniel; Sekandi, Juliet N; Musiimenta, Angella
    Although mobile health (mHealth) interventions have shown promise in improving health outcomes, most of them rarely translate to scale. Prevailing mHealth studies are largely small-sized, short-term and donor-funded pilot studies with limited evidence on their effectiveness. To facilitate scale-up, several frameworks have been proposed to enhance the generic implementation of health interventions. However, there is a lack of a specific focus on the implementation and integration of mHealth interventions in routine care in low-resource settings. Our scoping review aimed to synthesize and develop a framework that could guide the implementation and integration of mHealth interventions. We searched the PubMed, Google Scholar, and ScienceDirect databases for published theories, models, and frameworks related to the implementation and integration of clinical interventions from 1st January 2000 to 31st December 2023. The data processing was guided by a scoping review methodology proposed by Arksey and O'Malley. Studies were included if they were i) peer-reviewed and published between 2000 and 2023, ii) explicitly described a framework for clinical intervention implementation and integration, or iii) available in full text and published in English. We integrated different domains and constructs from the reviewed frameworks to develop a new framework for implementing and integrating mHealth interventions. We identified eight eligible papers with eight frameworks composed of 102 implementation domains. None of the identified frameworks were specific to the integration of mHealth interventions in low-resource settings. Two constructs (skill impartation and intervention awareness) related to the training domain, four constructs (technical and logistical support, identifying committed staff, supervision, and redesigning) from the restructuring domain, two constructs (monetary incentives and nonmonetary incentives) from the incentivize domain, two constructs (organizational mandates and government mandates) from the mandate domain and two constructs (collaboration and routine workflows) from the integrate domain. Therefore, a new framework that outlines five main domains-train, restructure, incentivize, mandate, and integrate (TRIMI)-in relation to the integration and implementation of mHealth interventions in low-resource settings emerged. The TRIMI framework presents a realistic and realizable solution for the implementation and integration deficits of mHealth interventions in low-resource settings. MEDLINE
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    Labour Care Guide implementation as a decision-making tool for monitoring labour among healthcare providers in Uganda: protocol for a mixed-methods study
    (British Medical Journal Publishing Group, 2024-04) Mugyenyi, Godfrey R; Byamugisha, Josaphat; Tumuhimbise, Wilson; Atukunda, Esther; Yarine, Fajardo T
    IntroductionThe new WHO Labour Care Guide (LCG), also regarded as the ‘next-generation partograph’, is a core component of 2018 WHO consolidated guidelines on intrapartum care for positive childbirth experience. The Ugandan Ministry of Health is in the process of adopting the new WHO LCG with no local context-specific data to inform this transition. We will explore potential barriers and facilitators to healthcare providers’ (HCPs) sustained engagement in labour monitoring in Mbarara city, Southwestern Uganda, and use the data to refine the new WHO LCG and develop a suitable implementation strategy to effectively integrate LCG into routine maternity care in Uganda. We shall then assess effectiveness, validity and other preliminary implementation outcomes of using the new LCG in detecting prolonged labour.Methods and analysisThe study will use a mixed-methods approach to identify key LCG user perspectives to refine and customise the WHO LCG among 120 HCPs and stakeholders involved in maternity care and labour monitoring within facilities in Southwestern Uganda. The refined prototype will be deployed and used to monitor labour in all 14 basic and comprehensive emergency obstetric and newborn care facilities in the study area. We will review labour outcomes of 520 patients monitored using the new LCG and compare these outcomes with a historical cohort of 520 patients monitored using the partograph. The main effectiveness outcome will be the proportion of women diagnosed with prolonged labour and/or obstructed labour.Ethics and disseminationEthical approval was obtained from the Mbarara University of Science and Technology Research Ethics Committee (MUST-2023-808) and Uganda National Council for Science and Technology (HS2864ES). We shall obtain written informed consent from each participant. The results of this study will be published in international peer-reviewed journals and presented to the Ugandan Ministry of Health as policy briefs and at selected national/international conferences.Trial registration numberNCT05979194.
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    A Mobile Health App May Improve Maternal and Child Health Knowledge and Practices among Rural Women with Limited Education in Uganda. A Pilot Randomized Controlled Trial
    (JAMIA open, 2022) Musiimenta, Angella; Tumuhimbise, Wilson; Atukunda, Esther C.; Mugaba, Aaron T.; Asasira, Justus; Katusiime, Jane; Zender, Raphael; Pinkwart, Niels; Mugyenyi, Godfrey Rwambuka; Haberer, Jessica E.
    This article describes the impact of a mobile health app (MatHealth App) on maternal and child health knowledge and practices among women with limited education. Pregnant women initiating antenatal care (ANC) were randomized (1:1) to the MatHealth App versus routine care. Participants were followed until 6 weeks after delivery. Questionnaires for assessing knowledge and practices were administered to participants from both arms at baseline and endline. Using logistic regression, we estimated the difference in odds of having maternal health knowledge. We reviewed clinic records to capture maternal health practices. Of the 80 enrolled participants, 69 (86%) completed the study with a median follow-up of 6 months. Women in the MatHealth arm had 8.2 (P ¼ .19), 3.6 (P ¼ .14), and 6.4 (P ¼ .25), respectively higher odds of knowing (1) the recommended gestation period for starting ANC, (2) the recommended number of ANC visits, and (3) the timing and frequency of recommended human immunodeficiency virus (HIV) testing, respectively, compared to those in the routine care arm. All women in the MatHealth App arm exclusively breastfed their babies, and brought them at 6 weeks for HIV testing, compared to the routine care arm. Just over half of the women attended at least 4 prenatal visits across the 2 arms. The main reason for noncompliance to ANC appointments was a lack of transport to the clinic. The app increased knowledge and practices although not reaching statistical significance. Future efforts can focus on addressing social and economic issues and assessing clinical outcomes.
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    A Mobile Health App may Improve Maternal and Child Health Knowledge and Practices among Rural Women with Limited Education in Uganda: A Pilot Randomized Controlled Trial
    (JAMIA open, 2022) Musiimenta, Angella; Tumuhimbise, Wilson; Atukunda, Esther C.; Mugaba, Aaron T.; Asasira, Justus; Katusiime, Jane; Zender, Raphael; Mugyenyi, Godfrey Rwambuka; Haberer, Jessica E.
    This article describes the impact of a mobile health app (MatHealth App) on maternal and child health knowledge and practices among women with limited education. Pregnant women initiating antenatal care (ANC) were randomized (1:1) to the MatHealth App versus routine care. Participants were followed until 6 weeks after delivery. Questionnaires for assessing knowledge and practices were administered to participants from both arms at baseline and endline. Using logistic regression, we estimated the difference in odds of having maternal health knowledge. We reviewed clinic records to capture maternal health practices. Of the 80 enrolled participants, 69 (86%) completed the study with a median follow-up of 6 months. Women in the MatHealth arm had 8.2 (P = .19), 3.6 (P = .14), and 6.4 (P = .25), respectively higher odds of knowing (1) the recommended gestation period for starting ANC, (2) the recommended number of ANC visits, and (3) the timing and frequency of recommended human immunodeficiency virus (HIV) testing, respectively, compared to those in the routine care arm. All women in the MatHealth App arm exclusively breastfed their babies, and brought them at 6 weeks for HIV testing, compared to the routine care arm. Just over half of the women attended at least 4 prenatal visits across the 2 arms. The main reason for noncompliance to ANC appointments was a lack of transport to the clinic. The app increased knowledge and practices although not reaching statistical significance. Future efforts can focus on addressing social and economic issues and assessing clinical outcomes
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    An Overview of Data Science Innovations, Challenges and Limitations Towards Real-World Implementations in Global Health
    (Springer, Cham., 2020) Kimera, Richard; Kaggwa, Fred; Mwavu, Rogers; Mugonza, Robert; Tumuhimbise, Wilson; Munguci, Gloria; Kamuganga, Francis
    Health institutions are increasingly collecting vast amounts of patient data. However, mining data from those different institutions is not possible for various challenges. In this chapter, we will report on our experience on the trend of Data Science in Global Health in Uganda. The aim is to provide an insight into their challenges and limitations towards real-world implementation of a data science approach in global health.We also present a series of digital health projects that we implemented during the course of the project, and provide a critical assessment of the success and challenges of those implementations.