Background Despite advancement in Prevention of Mother to Child Transmission (PMTCT) services, the rate of MTCT of HIV in sub-Saharan Africa is still high. This is partly due to low retention of HIV positive mothers in HIV care. We sought to determine the level of retention and the factors associated with retention among HIV positive pregnant and breastfeeding mothers following accreditation of an antiretroviral therapy (ART) clinic to offer full time ART services in one of the lower health facilities in rural Western Uganda. Methods This study was a mixed methods study conducted in 5 health centres in rural Western Uganda from 10th April to 10th May 2017. A total of 132 retained and non-retained HIV positive pregnant and breastfeeding mothers were recruited. A Mother was categorized as retained if she had not missed her ART appointments at antenatal or postnatal clinic for ≥3 consecutive months. Questionnaires were administered and four focus group discussions were held. We used descriptive statistics to understand characteristics of mothers and their levels of retention. Thematic analysis was used to analyze qualitative data. Results About a third (35.6%) of the mothers were aged 18–24 with a median age of 26 (IQR 23, minimum age of 16 and maximum age of 39). More than half, 73 (55.3%) of all mothers were in HIV care for 3–24 months and about 116(87.9%) of all mothers were retained in HIV care. This was an improvement from 53% reported in 2015. We found lack of formal education, lack of disclosure of HIV status to the spouse, perceived lack of confidentiality and self stigmatization as factors hindering retention. The desire to have an HIV free baby, fear of death and opportunistic infections, support from significant others and community groups were factors associated with retention. Conclusions We observed improved retention in lower health centres and to achieve 100% retention, we recommend interventions such as sensitizing HIV positive mothers on disclosure of HIV status to spouse, maintaining confidentiality of client information at the clinic, support to girl child education and formation of community support groups. Trial registration This study was retrospectively registered with the Uganda National Council for Science and Technology (UNCST), registration receipt number 10961 on the 9th March, 2018.
Aim To determine the health facility‐based perinatal mortality rate, its causes and avoidable factors using the perinatal mortality surveillance and response guidelines. Design This was an action study conducted in one of the districts in Western Uganda from 1 January–31 December 2019. Methods A total of 20 perinatal death cases were recruited consecutively. Data were collected using a Ministry of Health Perinatal Death Surveillance and Response (PDSR) questionnaire containing questions on pregnancy, delivery and immediate postnatal care. We used descriptive statistics to describe key data elements. Results We found a health facility‐based perinatal mortality rate of 17.3 deaths per 1,000 live births. Birth asphyxia was the most common cause of perinatal deaths. Seven, three and ten mothers delayed seeking, reaching and receiving appropriate health care, respectively.
Introduction: Despite being referred to as one of the country's "food baskets", 41% of children, 6-59 months of age in the Rwenzori sub-region, Western Uganda are stunted. Stunting is a form of chronic malnutrition in which children are short for their age. In this study, we established the prevalence and determinants of stunting in one of the sub-counties in this region. Methods: This was a cross-sectional descriptive study conducted in one of the sub-counties in the Rwenzori sub-region, Western Uganda from May 26 th to June 26 th , 2018. A total of 372 mothers and their children were recruited using systematic sampling. Data was collected using a questionnaire. Stunting was determined by taking child's height or length and comparing it with child's age. A child whose height or length for age index was less than −2 Standard Deviations (SD) was considered stunted. We used descriptive statistics to understand characteristics of mothers and multivariable logistic regression model to obtain the determinants of stunting. Data was analyzed using SPSS version 20. Results: A total of 372 mothers and their children were included in this study; majority, 307 (83.0%) of the children were 6-24 months old and nearly half, 167 (44.9%) were stunted. We found that reserving food stock for use in the dry season (aOR = 0.23, CI = 0.08-0.62, p = 0.004), deworming children (aOR = 0.32, CI = 0.18-0.54, p = 0.001) and the family earning at least 10,000 Ushs (2.7USD
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