Background: Research into aetiologies and prevention of the commonest cancers and implementation of primary and secondary prevention can reduce cancer risk and improve quality of life. Moreover, monitoring the prevalence of cancer risk factors in a specific population helps guide cancer prevention and early detection efforts and national cancer control programming. Objective: This article aims to provide the scope and findings of cancer risk studies conducted in Uganda to guide researchers, health-care professionals, and policymakers. Methods: Between November 2019 to January 2020, we searched peer-reviewed published articles in Pubmed, EMBASE and Cochrane Library (Cochrane central register of controlled trials-CENTRAL). We followed the recommendation of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses – the PRISMA. The primary focus was to identify cancer risk and prevention studies conducted in Uganda and published in peer-reviewed journals from January 2000 and January 2020. We used key Boolean search terms with their associated database strings. Results: We identified 416 articles, screened 269 non-duplicate articles and obtained 77 full-text articles for review. Out of the 77 studies, we identified one (1%) randomized trial, two (2.5%) retrospective cohort studies and 14 (18%) case-control studies, 46 (60%) cross-sectional studies, five (6.4%) ecological studies, three panel studies (4%) and six (8%) qualitative studies. Cervical cancer was the most studied type of cancer in Uganda (23.4%, n = 18 studies), followed by lymphomas – both Hodgkin and Non-Hodgkin sub-types (20.7%), n = 16 studies) and breast cancer (15.6%, n = 12 studies). In lymphoma studies, Burkitt lymphoma was the most studied type of lymphoma (76%, n = 13 studies). The studies concentrated on specific cancer risk awareness, risk perceptions, attitudes, uptake of screening, uptake of human papillomavirus vaccination, the prevalence of some of the known cancer risk factors and obstacles to accessing screening services. Conclusion: The unmet need for comprehensive cancer risk and prevention studies is enormous in Uganda. Future studies need to comprehensively investigate the known and putative cancer risk factors and prioritize the application of the higher-hierarchy evidence-generating epidemiological studies to guide planning of the national cancer control program.
Background: In Uganda women with disabilities attend antenatal care (ANC) while pregnant, however, majority of these deliver from the hands of Traditional Birth Attendants (TBAs) due to due to fear of being mistreated by skilled birth attendants. We explored the determinants of the maternal health seeking behavior of women with disability in Busiro health sub district (HSD), Wakiso district, Uganda.Methods: A community based cross-sectional study involving quantitative and qualitative methods of data collection was conducted among 182 participants. Quantitative data were collected from disabled women, and qualitative data from six key informants (midwives and in-charges) at selected health facilities in Busiro HSD, Wakiso district. Logistic regression was used to determine the factors influencing the decision to seek maternal health care services (ANC and delivery at health facilities) among women with disability. Qualitative data were analyzed by content analysis.Results: The findings revealed that 82.3% of women with disability attended ANC during pregnancy, and of these, 80.8% delivered their babies at health facilities. Attendance of ANC by the women with disability was influenced by parity (having 1-3 children) (AOR 7.7; 95% CI: 0.249-239.040), mode of delivery-normal delivery verses caesarian section (AOR 2.6, 95%CI: 0.296-22921), place visited during pregnancy TBA visa vie public health facilities (AOR 4.5, 95%CI: 0.922-22.576), and distance to the health facility being less than 5 Kilometres (AOR 2.3 95% CI: 0.695-7.661). Conclusion: There is need to intensify awareness of the use of skilled health workers during pregnancy and child birth to women with disability in the communities so as to improve uptake of maternal health care services.
BackgroundOral health promotion(OHP) during pregnancy is an important global public health and basic human right issue related to quality of life. Several statements and guidelines have been published emphasizing the need for improved oral health care of pregnant mothers, prenatal care providers have missed this critical opportunity. In this study, we assessed factors influencing adoption of oral health promotion by Antenatal care providers.Materials and MethodsA descriptive cross-sectional study design that employed both quantitative and qualitative data collection methods and analysis. 152 samples determined using Yamane’s 1967 and stratified sampling technique was used. Three FGDs and six KI interviews were held. Univariate, bivariate and multivariate analyses were done using SPSS (20.0) and ATLAS Ti for qualitative analysis.ResultsAdoption of OHP was low 28% (42). Factors influencing adoption were age of respondents(p=0.032*), level of care of health facility (p=0.004*), good understanding between dentists and ANC providers (aOR=0.283, 95%CI=0.084-0.958, p= 0.042*), availability of practice guideline for OHP in ANC (aOR=0.323, 95%CI=0.108-0.958, p= 0.043*), number of years at work (p=0.084), being knowledgeable (aOR=2.143, 95%CI=0.864-5.311, p= 0.100), having skills to advance OHP(aOR=0.734, 95%CI=0.272-1.984, p= 0.542), Management being good at influencing new practices (aOR=00.477.734, 95%CI=0.227-2.000, p= 0.477). More emphasis on national and local of oral health issues, continuous staff training on oral health, dissemination of National oral health policy (NOHP) were some of key issues that emerged from the qualitative results.ConclusionAdoption of OHP was low. This was attributed to age, number of years spent at work, level of health facility, having good understanding between dentists and ANC providers, availability of practice guidelines, dissemination of National oral health policy, continuous staff training. We recommend the current NOHP to be reviewed, develop prenatal OHC guidelines, enhance the capacity of ANC providers through training, collaboration with dentists and launch official adoption of OHP.
Aim: To assess the utilization of PDAs in addressing the avoidable causes of perinatal mortality in the eastern region of Uganda. Methodology: A cross-section design using a mixed method was conducted between 2014-2015 at Iganga, Bugiri, and Kamuli general hospitals in the East-Central region of Uganda. The interviews involved 115 health workers who included Doctors, Nurses/Midwives, Clinical officers, and Laboratory and Theatre staff. These were drawn from four departments including the Maternity ward, Outpatient department, Theatre, and pediatric ward. Hospital top and departmental managers formed the key informants for this study. Annual reports for the period 2009/10-2012/13 were reviewed. In addition, monthly reports for the calendar year 2013 together with patients’ clinical case notes and patients’ registers were also reviewed to determine the magnitude and causes of perinatal mortality. Factors contributing to perinatal death were assessed and categorized into fetal, maternal, and health facility factors. Results: Results revealed a high and rising perinatal mortality rate of 70/1,000 live births and a decreasing maternal mortality ratio of 363/100,000 live births. Most perinatal deaths were fresh stillbirths 48/88 which occurred during the intrapartum period and the majority of early neonatal death was due to birth asphyxia. None of the health facilities was conducting perinatal death audits and the quality of data used for perinatal death audits was inadequate and was scored poorly. Challenges hindering utilization of perinatal death audits included lack of staff sensitization and training, work overload, lack of motivation, fear of blame and litigation, political interference, and lack of support from the community. Conclusion: There was a high prevalence of perinatal deaths in east-central Uganda yet none of the hospitals was conducting perinatal death reviews. Recommendations: Health workers should be trained on perinatal death audit tools and guidelines. Records departments to revitalize with tools and personnel for effective data management.
Introduction: Health workforce shortage is a major threat to global public health with a greater implication for low-resourced countries. The right placement of the available staff in many health facilities remains a challenge due to inadequate information on exact workload and work pressure that staff undergo in course of work. This study aimed to determine the need for key health workforce cadre in Kuluva hospital using Workload Indicators of Staffing Need (WISN) methodology. Method: The study followed a predominantly quantitative approach of Workload Indicator Staffing Needs (WISN) methodology. We held a meeting with hospital management to understand policy issues and procedures. The key staff were interviewed in departments, available records reviewed, practices observed to establish the available working time, activity standards and time taken to perform other supportive activities. Service statistics was generated from HMIS data of 2016/17. Data was analyzed manually using calculator and Microsoft Excel spreadsheet. Results All cadre categories had the same available working time of 1,504 hours in a year with 105 staff of the studied cadres required to perform all activities in Kuluva hospital based on WISN calculation. Although overall work pressure was 30%, 5 out of 7 staff cadre categories experienced work pressure of varying degrees – medical officers (70%), laboratory staff (70%) and clinical officers (60%) were most affected compared to nurses (30%) and midwives (10%). There was perfect number of anesthetists but surplus nursing assistants than needed by the hospital. Amidst shortage, the critical cadres still spent significant time on non-professional activities; medical officers (24%) and midwives (25%). Conclusion These findings can provide insight into the management of Kuluva hospital to address the current disparities in the health workforce in terms of numbers and skill mix for continuous improvement of health service delivery to the population it serves.
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