Browsing by Author "Zikusooka, Amos"

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    Adolescents Discussing Sexual Behaviors With Key Influencing Audiences
    (Global Journal of Health Science, 2018) Nalukwago, Judith; Crutzen, Rik; Bart, van den Borne; Bukuluki, Paul M.; Bufumbo, Leonard; Batamwita, Richard; Zikusooka, Amos; Thompson, Gretchen; Alaii, Jane
    There is an increasing concern on early initiation of sexual activity among adolescents, increasing sexually transmitted infections, and teenage pregnancy in Uganda. Adolescents perceptions of these sexual behaviors might be the result of discussing sexual and reproductive health issues with key influencing audiences. This study qualitatively explored the effect of sexuality discussions with key influencing audiences by means of in-depth interviews and focus group discussions with adolescents (N=83). Findings indicate that adolescence stage comes with changes of intense sexual desires, often presumed difficult to control thus leading adolescents to engage in sexual activities. Adolescents indicated that they were aware of the sexual behaviors such as condom use, contraception use, and multiple concurrent partnerships, but intertwined with persistent myths and misconceptions. Although discussing sexuality issues with someone was found to be instrumental, adolescent highlighted challenges that hinder discussion with key influencers. Challenges include, parents lack of time to talk to their children; some religious affiliations perceived to discourage use of contraception; limited skills of community health workers to address adolescent information needs; meetings held in groups not followed up with age-focused or one-on-one discussions; negative health workers’ attitudes and use of technical language; and peer pressure. These findings suggest the need to provide adequate and updated information to clear any misconceptions and strengthening of key influencers’ communication skills to gain confidence in addressing adolescent sexual and reproductive health needs.
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    Evaluation of the Obulamu? integrated health communication campaign in Uganda: results from a repeated cross-sectional household survey
    (Journal of Communication in Healthcare, 2021) Burke, Holly M.; Okumu, Eunice; Zikusooka, Amos; Batamwita, Richard; Nalukwago, Judith; Field, Samuel; Bernholc, Alissa; Martinez, Andres; Bufumbo, Leonard; Kimbowa, Musa; Coutinho, Sheila M.; Mack, Natasha; Alaii, Jane
    Uganda’s Obulamu? campaign delivered messages relevant to life stage to address evolving health needs of audiences at times they were likely to change behaviors. We estimated Obulamu?’s effects on HIV/AIDS, family planning, maternal and child health, tuberculosis, malaria, and nutrition behavioral outcomes. Methods: We conducted repeated cross-sectional household surveys with women, men, and children’s caregivers in 2015 and 2017 in 16 districts using multi-stage probability sampling weighted by population. Eleven pre-specified outcomes were evaluated in multivariable weighted regression models. Results: Survey 1 included 2,377 households with 4,012 individuals and survey 2 included 2,398 households with 3,563 individuals. After controlling for time and potentially confounding factors, we observed notable increases among people exposed to topicspecific messages in condom use with at least one non-marital, non-cohabiting partner in the last six months; recent male circumcision; seeking tuberculosis screening/testing for self; seeking tuberculosis screening/testing for child; delivery of baby in a facility; and caregiver seeking advice or treatment for child under five years with fever. Exposure did not appear to influence knowledge of antiretroviral therapy, delay sexual debut, breastfeeding infants and all of the household’s pregnant women/children less than five years sleeping under a net the night before the survey. Conclusion: Exposure to topic-specific messages was associated with improvements in six of the eleven outcomes. Across the health priority areas, we observed improvements in select HIV/AIDS, tuberculosis, and maternal and child health outcomes. We did not observe effects of exposure on select outcomes in the areas of family planning, malaria, or nutrition.
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    Gender norms associated with adolescent sexual behaviors in Uganda
    (International Social Science Journal, 2019) Nalukwago, Judith; Crutzen, Rik; Borne, Bart van den; Mukisa Bukuluki, Paul; Bufumbo, Leonard; Burke, Holly McClain; Field, Samuel; Zikusooka, Amos; Fiedler, Anne Akia; Alaii, Jane
    Gender norm attitudes and practices remain deeply entrenched in many African societies (Gibson et al. 2014; Wight et al. 2006). Countries driven by gender inequalities that constrain Judith Nalukwago, the lead author of this article, has a PhD in Public Health from the Faculty of Health, Medicine and Life Sciences of Maastricht University, The Netherlands. She is a health promotion scholar, practitioner and a behavioural scientist with grounded skills in both theoretical and practical implementation of social and behaviour change interventions. She has a background in monitoring, evaluation, research, learning/ knowledge management, and adolescent health programming from an academic and programme implementation perspective. Email: j.nalukwago@maastrichtuniversity.nl individual behaviour in sexual interactions often have the highest rates of HIV and teenage pregnancies (Hardee et al. 2014; Richards et al. 2013; Van den Berg et al. 2013). Women and girls face more gendered risks than their male counterparts, which affects their social, economic and political opportunities (Mbonye et al. 2012; UNAIDS 2016; UNICEF 2015)
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    Socio-Cognitive Factors Associated With Condom Use, Multiple Sexual Partnerships, and Contraception Use Among Sexually-Active Adolescent Girls in Uganda
    (Global Journal of Health Science, 2018) Nalukwago, Judith; Crutzen, Rik; Borne, Bart van den; Bukuluki, Paul M.; Bufumbo, Leonard; Burke, Holly M.; Field, Samuel; Zikusooka, Amos; Fiedler, Anne A.; Alaii, Jane
    Many adolescent girls start sexual activity early which exposes them to health risks of HIV and unplanned pregnancies. However, adolescent girls are less likely than boys to initiate discussion or demand use of condoms. Multiple sexual partnerships among girls are reported to be on the rise with eminent transactional sex and pre-marital relationships. The unmet need for contraception among adolescent girls is also high. A cross-sectional survey covering 16 districts in Uganda assessed the socio-cognitive factors associated with condom use, multiple sexual partnerships and contraception use among sexually active adolescent girls (N=255). There were strong associations between feeling confident to discuss contraceptive methods with a partner (OR = 9.41, 95 % CI = 3.54, 25.06), being comfortable to use contraception (OR = 30.61, 95% CI = 4.10, 228.64), discussing contraception use with someone (OR = 10.53, 95% CI = 5.61, 19.78), and contraception use. Whereas knowledge was found to have no significant relationship with service uptake, information services remain important in clearing any misconceptions and addressing any health concerns. It is imperative to explore communication factors including skills development and providing adequate health information to guide dialogue among adolescents and their key influencers.