Background In Uganda, many working mothers stop breast-feeding before the end of the mandatory maternity leave of 60 days. Inadequate breast-feeding is a risk factor for infant morbidity and mortality. Thus, understanding of the factors that influence breast-feeding is essential so as to advocate for the appropriate breast-feeding practices. This cross-sectional study assessed the pre-lacteal feeding (PLF), early initiation of breast-feeding (EIBF) and exclusive breast-feeding (EBF) and the associated factors for PLF, EIBF and EBF among working mothers in health facilities in Lira District, Northern Uganda. Results Among 376 mothers who participated, the prevalence of PLF, EIBF and EBF was 23.2%, 67.0% and 43.9%, respectively. Mode of delivery was significantly associated with PLF (AOR = 0.39, 95% CI 0.22–0.68, p < 0.01), while mode of delivery (AOR = 3.77, 95% CI 2.19–6.47, p < 0.01), length of daily working time (AOR = 0.49, 95% CI 0.29–0.82, p < 0.01) and paid maternity leave (AOR = 0.45, 95% CI 0.22–0.95, p < 0.05) were the statistically significant factors associated with EIBF. Age-group, income level, mode of delivery (AOR = 0.26, 95% CI 0.09–0.74, p < 0.05), distance to workplace (AOR = 0.45, 95% CI 0.26–0.78, p < 0.01), paid maternity leave (AOR = 0.45, 95% CI 0.22–0.95, p < 0.01), breast-feeding space (AOR = 0.30, 95% CI 0.16–0.59, p < 0.05) and breast-feeding break (AOR = 0.84, 95% CI 0.47–1.50, p < 0.01) were the significant factors associated with EBF. Conclusions Exclusive breast-feeding and pre-lacteal feeding among working mothers in health facilities in Lira District are lower than the national averages, but prevalence of early initiation of breast-feeding is higher than the national average.
Background: Outputs from the quantifications are used to advocate and allocate funding and develop supply plans to ensure the availability of medicines. However, the actual consumption is not always equal to the forecast, and thus forecasting teams often adjust further to improve the forecast accuracy. The study aimed to determine the forecast accuracy of the final forecast, the effect of adjustments, and the factors that affect the forecast accuracy of ARVs in Uganda. Methods: A descriptive study was conducted using quantitative and qualitative data collection methods. The statistical forecasts, final forecasts, and actual consumption data from January 2016 to December 2018 were collected retrospectively from the Ministry of Health and the web-based ordering and reporting system (WAOS). Microsoft Excel was used for data analysis. The mean average percentage error (MAPE) was used to measure forecast accuracy, and a student t-test was used to determine the significance of adjustments. Key informant interviews were done to determine the factors affecting forecast accuracy. Thematic approach was used to analyse qualitative data. Results: The national final forecast MAPE ranged from 2.33% to 5.15% (Jan 2016 -Jan 2019), while the statistical MAPE ranged from 2.65% to 4.31% (Aug 2017 - Jan 2019). The MAPEs for adult ARVs were generally lower than those of pediatric ARVs, and a variation in forecast accuracy with one of the central warehouses was noted. Adjustments generally lowered the MAPE for adult ARVs but increased the MAPE for most pediatric ARVs. Adjustments were significant for 53.8% (n=13, p=0.05) of the ARVs. Factors including dispensing practices, the complexity of the quantification, adherence to treatment guidelines, data quality, product availability, and quantification team attributes were identified to affect the forecast accuracy Conclusions: The final and statistical forecasts had good accuracy, and adjustments improved the accuracy of adult ARV forecasts while decreasing the accuracy for pediatric ARVs. The accuracy of the forecast was affected by the quantification complexity, product usage, availability, and team attributes. Forecast accuracy of new drugs and the degree of significance of the factors affecting forecasting should be studied further. Trial registration: Not Applicable
Objectives General Objective: To determine the level of male partner involvement in complementary feeding practices and associated factors among households with children aged 6–24 months in Abim District so as to devise most effective strategies, approaches and interventions for encouraging male partner involvement with a view of improving adoption of optimal complementary feeding practices in children aged 6–24 months. Research Questions - What is the level of male partner involvement in complementary feeding practices among households with children aged 6–24 months? - What factors are associated with male partner involvement in complementary feeding practices among households with children aged 6–24 months? Methods A cross-sectional study involving both quantitative (382 mothers) and qualitative (2 FGDs and 2 KIIs) approaches was conducted. Data entry was done and checked for completeness and consistency using Epi Data 3.0. Data analysis was done using SPSS version 20. Descriptive statistics were used to define the characteristics of study participants. At bivariate analysis, Pearson's chi square tests were used to establish the association between the dependent and each independent variable. At multivariate analysis, a binary logistic regression was executed to establish factors associated with male partner involvement in complementary feeding using odds ratios. Strength of association was determined at 5% level of significance (p < 0.05). Results The level of male partner involvement in complementary feeding in this study was good (68%). It was associated with; tertiary education of mother (OR = 1.38, CI 95% = 0.01 to 0.08; p = 0.00), mothers in formal employment (OR = 1.03; CI 95% = 1.001 t0 3.05: p = 0.001), husbands in formal employment (OR = 1.75; CI 95%: 1.05 to 2.89; p = 0.021) and husbands aged between 25–29 years (OR = 3.73; CI 95% = 1.96 to 7.07; p = 0.002). Conclusions Male partner involvement in complementary feeding in Abim district is good. It is associated with; formal employment for mothers and their partners, mothers with tertiary education, and husbands aged between 25–29 years. The government needs to strengthen multi-sectoral integration to address the gender gaps and barriers that hinder male partner involvement in the broader infant and young child feeding practices. Funding Sources None.
In northern Uganda, it is estimated that over 3,541 children in the districts of Kitgum, Pader and Lamwo were affected by nodding disease syndrome (NDS) by December 2013. The nodding Disease syndrome continues to manifest itself in Children in Akwang, Kitgum and other parts of Northern Uganda causing progressive cognitive dysfunction, neurological deterioration and stunted growth. This study sought to determine the nutritional status of children with NDS in Akwang Sub County, Kitgum District, identify the factors influencing this nutritional status and delineate the coping strategies at the household level. Methods: We used mixed methods, Children between 5–18 years with Nodding Disease Syndrome were chosen after their parents consented, and Akwang HCIII in Akwang sub county, Kitgum district was considered. This was majorly done for all children registered with the health Centre III and suffering from NDS, 123 children aged (5–18 years) were sampled and their parents/guardians were then traced using the snowballing method to their respective households from where consent was sought. They then participated by way of answering the questionnaire and taking of the anthropometric measurements of the children. We then used SPSS for analyzing quantitative data and Dedoose for qualitative data. Results: A total of 123 participants took part in the Study. Participants reported that prevalence of malnutrition in the NDS children is very high and this could be attributed to seizures while feeding, religious beliefs and age at weaning. Various coping mechanism include rearing animals, planting different kinds of crops for feeding and rearing cows and goats which are used as food to eat. This would play an important role in fighting malnutrition in NDS children in Northern Uganda. Conclusion: There is an urgent need to address the through factors that are associated with malnutrition among NDS children, and to strengthen the identified coping mechanisms. Empowering the care takers and prioritizing improvement on economic status could help in fighting malnutrition in NDS children.
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