Browsing by Author "Weber, Rachel"

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    Decision-Making on Intra-Household Allocation of Bed Nets in Uganda: Do Households Prioritize the most Vulnerable Members
    (Malaria journal, 2014) Lam, Yukyan; Harvey, Steven A.; Monroe, April; Muhangi, Denis; Loll, Dana; Kabali, Asaph Turinde; Weber, Rachel
    Access to insecticide-treated bed nets has increased substantially in recent years, but ownership and use remain well below 100% in many malaria endemic areas. Understanding decision-making around net allocation in households with too few nets is essential to ensuring protection of the most vulnerable. This study explores household net allocation preferences and practices across four districts in Uganda.Data collection consisted of eight focus group discussions, twelve in-depth interviews, and a structured questionnaire to inventory 107 sleeping spaces in 28 households.In focus group discussions and in-depth interviews, participants almost unanimously stated that pregnant women, infants, and young children should be prioritized when allocating nets. However, sleeping space surveys reveal that heads of household sometimes receive priority over children less than five years of age when households have too few nets to cover all members. When asked directly, most net owners highlight the importance of allocating nets to the most biologically vulnerable household members. This is consistent with malaria behaviour change and health education messages. In actual allocation, however, factors other than biological vulnerability may influence who does and does not receive a net.
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    “People Will Say That I Am Proud”: A Qualitative Study of Barriers to Bed Net Use away from Home in Four Ugandan Districts
    (Malaria journal, 2014) Monroe, April; Harvey, Steven A.; Lam, Yukyan; Muhangi, Denis; Loll, Dana; Kabali, Asaph Turinde; Weber, Rachel
    Despite increased access and ownership, barriers to insecticide-treated bed net (ITN) use persist. While barriers within the home have been well documented, the challenges to net use when sleeping away from home remain relatively unexplored. This study examines common situations in which people sleep away from home and the barriers to ITN use in those situations.To explore these issues, a group of researchers conducted 28 in-depth interviews and four focus groups amongst adults from net-owning households in four Ugandan districts.In addition to sleeping outside during hot season, participants identified social events, livelihood activities, and times of difficulty as circumstances in which large numbers of people sleep away from home. Associated challenges to ITN use included social barriers such as fear of appearing proud, logistical barriers such as not having a place to hang a net, and resource limitations such as not having an extra net with which to travel. Social disapproval emerged as an important barrier to ITN use in public settings.Unique barriers to ITN use exist when people spend the night away from home. It is essential to identify and address these barriers in order to reduce malaria exposure in such situations. For events like funerals or religious “crusades” where large numbers of people sleep away from home, alternative approaches, such as spatial repellents may be more appropriate than ITNs. Additional research is required to identify the acceptability and feasibility of alternative prevention strategies in situations where ITNs are unlikely to be effective.
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    Professional views on priorities for cervical cancer policy in Uganda: a qualitative study
    (The Lancet Global Health, 2022) Anumolu, Natalie; Jankowksi, Courtney; Anguzu, Ronald; Kasasa, Simon; Dickson-Gomez, Julia; Banura, Cecily; Weber, Rachel
    Cervical cancer incidence in Uganda is three-times that of the global average, and is a leading cause of mortality for women. The main cause is human papillomavirus (HPV). Women living with HIV have a greater risk of acquiring HPV and need better cervical cancer care than their HIV-negative counterparts. Although funding and infrastructure exist for HIV control, they are not in place for cervical cancer. We aimed to assess Ugandan health professionals' knowledge of and perspectives regarding cervical cancer among women with HIV to identify perceived barriers and facilitators, and to guide potential interventions to reduce the burden of cervical cancer. We used qualitative interviews to obtain primary data from professionals working in the HIV field in Uganda, identified through purposive and snowball sampling, and through consultation with colleagues at The AIDS Support Organisation (TASO) and Makerere University in Kampala. Inclusion criteria required the respondent to be a provider, researcher, community health worker, or other authority on cervical cancer and HPV and to be conversant in English. Exclusion criteria included being younger than 18 years. Written and verbal informed consent were obtained in accordance with the Medical College of Wisconsin and Makerere University human subjects protection protocols. Virtual, 1 h-long interviews were conducted and recorded. Interviews consisted of open-ended questions exploring perspectives on, knowledge about, and practices surrounding HPV and cervical cancer among women with HIV in Uganda. Institutional review board approval was obtained from TASO, the Uganda National Council for Science and Technology, and Medical College of Wisconsin. Transcripts were analysed and coded via MaxQDA software for common themes; emerging codes were generated from meaningful quotes as used in specific interviewee contexts of facilitators and barriers to HPV vaccination, cervical cancer screening, and treatment.