Background Safeguarding the psychological well-being of healthcare workers (HCWs) is crucial to ensuring sustainability and quality of healthcare services. During the COVID-19 pandemic, HCWs may be subject to excessive mental stress. We assessed the risk perception and immediate psychological state of HCWs early in the pandemic in referral hospitals involved in the management of COVID-19 patients in Uganda. Methods We conducted a cross-sectional survey in five referral hospitals from April 20–May 22, 2020. During this time, we distributed paper-based, self-administered questionnaires to all consenting HCWs on day shifts. The questionnaire included questions on socio-demographics, occupational behaviors, potential perceived risks, and psychological distress. We assessed risk perception towards COVID-19 using 27 concern statements with a four-point Likert scale. We defined psychological distress as a total score > 12 from the 12-item Goldberg’s General Health Questionnaire (GHQ-12). We used modified Poisson regression to identify factors associated with psychological distress. Results Among 335 HCWs who received questionnaires, 328 (98%) responded. Respondents’ mean age was 36 (range 18–59) years; 172 (52%) were male. The median duration of professional experience was eight (range 1–35) years; 208 (63%) worked more than 40 h per week; 116 (35%) were nurses, 52 (14%) doctors, 30 (9%) clinical officers, and 86 (26%) support staff. One hundred and forty-four (44%) had a GHQ-12 score > 12. The most common concerns reported included fear of infection at the workplace (81%), stigma from colleagues (79%), lack of workplace support (63%), and inadequate availability of personal protective equipment (PPE) (56%). In multivariable analysis, moderate (adjusted prevalence ratio, [aPR] = 2.2, 95% confidence interval [CI] 1.2–4.0) and high (aPR = 3.8, 95% CI 2.0–7.0) risk perception towards COVID-19 (compared with low-risk perception) were associated with psychological distress. Conclusions Forty-four percent of HCWs surveyed in hospitals treating COVID-19 patients during the early COVID-19 epidemic in Uganda reported psychological distress related to fear of infection, stigma, and inadequate PPE. Higher perceived personal risk towards COVID-19 was associated with increased psychological distress. To optimize patient care during the pandemic and future outbreaks, workplace management may consider identifying and addressing HCW concerns, ensuring sufficient PPE and training, and reducing infection-associated stigma.

Background Women’s support can improve uptake of voluntary medical male circumcision (VMMC). We assessed the level of women’s support for VMMC and associated factors in fishing settlements on the shores of Lake Victoria in Uganda, to inform interventions aimed at increasing the uptake of safe male circumcision services in such high-risk populations. Methods We conducted a cross-sectional study, employing mixed methods of data collection, at Kasenyi and Kigungu landing sites in April 2018. We included women aged 18–49 years, who had stayed at the landing sites for ≥3 months. We obtained qualitative data using focus group discussions (FGDs), and interviewer-administered semi-structured questionnaires for quantitative data. The tool captured demographic characteristics, community factors including cultural norms and beliefs, women’s experiences, and health facility-related factors. The dependent variable was derived from the response to the question: "Would you encourage your partner/husband to go for VMMC?", and used as a proxy for support of VMMC. We used modified Poisson regression to identify factors associated with women’s support for VMMC. Qualitative data were analysed using thematic content analysis. Results We enrolled 313 women with a mean age of 28 (SD±6.8) years. Of the 313 women, 230 (73.5%) supported VMMC. Belief that VMMC increases penile hygiene (Adjusted prevalence ratio [aPR]=1.9; CI: 1.8–3.2), performing VMMC for religious reasons (aPR=1.9; CI: 1.8–2.9), preference for a circumcised man (aPR=1.3; CI: 1.2–1.5), belief that vaginal fluids facilitate wound healing (aPR=1.9; CI: 1.3–2.7), and knowledge about when a man can resume sex (4 weeks) after circumcision (aPR=2.1; CI: 1.8–3.3) were associated with women’s support for VMMC. FGDs revealed that women were not adequately involved in VMMC activities for decision making. Conclusion The support for VMMC was high among women in the fishing communities. However, women perceived they were not involved in decision-making for VMMC and had several misconceptions, including a belief that vaginal fluids facilitate wound healing. The Ministry of Health and VMMC implementing partners should devise strategies to increase sensitization and involvement of women in VMMC decision-making without slowing service uptake.

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Background: Complications of preterm births are the largest cause of neonatal deaths and the second leading cause of deaths among children <5 years globally. The preterm birth rate in Uganda is estimated at 6.6%. Reduction of this rate is needed to achieve the United Nations Sustainable Development Goal to end all preventable deaths among newborns and children aged <5 years by 2030. We describe the trends and distribution of preterm births admissions in Uganda during 2015-2019 for advocacy, planning, and targeted interventions.Methods: We used national preterm birth admissions data from 2015-2019 abstracted from the District Health Information System 2 (DHIS2) to calculate national, regional and district annual incidence of preterm births admissions. DHIS2 defines preterm birth as birth occurring <37 weeks of gestation. We used preterm birth admissions as numerator and the total livebirths (LB) as the denominator. We used line graphs to demonstrate the trend of annual incidence for the national and regional levels and choropleth maps to show district level distribution. Significance of the trend of annual incidence was tested using modified Poisson regression with unbiased sandwich standard errors, considering calendar year as independent and preterm births admissions as dependent variableResults: The national annual incidence of preterm birth admissions/1,000 LB has significantly increased from 3 in 2015 to 14 in 2019 (Incidence Risk Ratio (IRR)=1.3, p=0.003). The annual incidence of preterm birth admissions/1,000 LB increased significantly in three regions of Uganda during 2015 -2019 (Central Region from 3 to 21, IRR=1.5, p<0.0001; Western Region from 4 to 15 IRR=1.2, p=0.039; Northern Region from 3 to 10, IRR=1.2, p=0.008; Eastern Region from 2 to 8, IRR=1.3, p=0.086). The Choropleth map showed minimal clustering of high incidence of preterm birth admissions at district level.Conclusion: Incidence of preterm birth admissions increased nationally and regionally in Uganda from 2015-2019. There is need to plan for and prepare health facilities to manage preterm labor and preterm babies, as well as identifying reasons for the increase. Equipping health facilities and training health workers to manage preterm labor and babies should be prioritized.