Not Enough Money and Too Many Thoughts: Exploring Perceptions of Mental Health in Two Ugandan Districts Through the Mental Health Literacy Framework.

Mental health disorders account for a heavy disease burden in Uganda. In order to provide culturally appropriate mental health prevention and treatment approaches, it is necessary to understand how mental health is conceptualized in the population. Three focus group discussions (FGDs) and 31 in-depth interviews (IDIs) were conducted with men and women aged 14 to 62 years residing in rural, urban, and semi-urban low-income communities in central and western Uganda to explore perceptions and knowledge of mental health. Interpretive thematic analysis was undertaken; results were organized through the lens of the mental health literacy framework. Environmental and societal stressors were identified as primary underlying causes of poor mental health. While participants recognized symptoms of poor mental health, gaps in mental health literacy also emerged. Mental health resources are needed in this setting and additional qualitative work assessing knowledge and attitudes toward mental health care seeking behavior can inform the development of acceptable integrated services

Not Enough Money and Too Many Thoughts: Exploring Perceptions of Mental Health in Two Ugandan Districts Through the Mental Health Literacy Framework.

Mental health disorders account for a heavy disease burden in Uganda. In order to provide culturally appropriate mental health prevention and treatment approaches, it is necessary to understand how mental health is conceptualized in the population. Three focus group discussions (FGDs) and 31 in-depth interviews (IDIs) were conducted with men and women aged 14 to 62 years residing in rural, urban, and semi-urban low-income communities in central and western Uganda to explore perceptions and knowledge of mental health. Interpretive thematic analysis was undertaken; results were organized through the lens of the mental health literacy framework. Environmental and societal stressors were identified as primary underlying causes of poor mental health. While participants recognized symptoms of poor mental health, gaps in mental health literacy also emerged. Mental health resources are needed in this setting and additional qualitative work assessing knowledge and attitudes toward mental health care seeking behavior can inform the development of acceptable integrated services

Household food insecurity and its association with self-reported male perpetration of intimate partner violence: a survey of two districts in central and western Uganda

Objectives This study aimed to determine the lifetime prevalence of male-perpetrated intimate partner violence (IPV), and to assess the association with food insecurity, sociodemographic factors and health risk behaviours in Uganda in the year preceding COVID-19-associated lockdowns.Design Population-based, cross-sectional household survey.Setting Urban, semiurban and rural communities of the Wakiso and Hoima districts in Uganda.Participants A total of N=2014 males aged 13–80 years participated in the survey. The current study included males who reported having ever been in a sexual union and responded to the IPV questions (N=1314).Measures Data were collected face-to-face from May 2018 to July 2019 using an interviewer-mediated questionnaire. Lifetime IPV perpetration was measured as ‘no physical and/or sexual IPV’, ‘physical’ versus ‘sexual violence only’, and ‘physical and sexual violence’. Past-year food insecurity was measured through the Food Insecurity Experience Scale and categorised into ‘none’, ‘low’ and ‘high’. Multinomial logistic regression was used to determine the crude and adjusted relative risk ratios (aRRRs) of IPV perpetration in relation to self-reported food insecurity, adjusting for sociodemographic and health risk behaviours.Results The prevalence of self-reported lifetime IPV perpetration was 14.6% for physical and 6.5% for sexual violence, while 5.3% reported to have perpetrated both physical and sexual IPV. Most (75.7%) males reported no food insecurity, followed by low (20.7%) and high (3.6%) food insecurity. In adjusted models, food insecurity was associated with increased risk of having perpetrated both physical and sexual violence (aRRR=2.57, 95% CI 1.52 to 4.32). IPV perpetration was also independently associated with having had more than one lifetime sexual partner and drinking alcohol, but not with education level or religion.Conclusion This study suggests that food insecurity is associated with male IPV perpetration, and more efforts are needed to prevent and mitigate the expected worsening of this situation as a result of the COVID-19 pandemic

Multinomial logistic regression showing relative risk ratios (RRR, 95% confidence interval (CI)) for the associations between selected independent variables and short-acting and contraceptive use across short -and long-term contraception use methods among 1635 women of reproductive age in Wakiso and Hoima districts in Uganda in 2020.

Multinomial logistic regression showing relative risk ratios (RRR, 95% confidence interval (CI)) for the associations between selected independent variables and short-acting and contraceptive use across short -and long-term contraception use methods among 1635 women of reproductive age in Wakiso and Hoima districts in Uganda in 2020.</p

List of legends.

Modern contraceptive use has increased globally, but unmet needs persist in low- and middle-income countries. This study in Uganda aimed to examine the prevalence and factors influencing the use of short-acting reversible contraceptives (SARC) like pills and long-term methods such as intrauterine devices. Limited evidence exists on the use of SARC and long-term methods in Uganda. Data from the Africa Medical and Behavioural Sciences Organization (AMBSO) Population Health Surveillance (APHS) in Hoima and Wakiso districts were analysed. Among the 1642 women aged 15–49 years, the prevalence of modern contraceptive use was 30% for SARC, and 18% for long-term method. Women with formal education were three times more likely to use long-term methods than those without formal education, relative risk ratios (RRR), 3.1–3.4, (95%CI 1.2–8.2). Joint decision-making for contraceptive use increased SARC usage, RRR 1.4 (95%CI 1.1–1.8). Urbanization played a role, with women in more urbanized Wakiso district less likely to use any modern contraception, RRR 0.6–0.7 (95%CI 0.5–0.9) compared to those living in the less urbanized Hoima. About half of the women in the study used modern contraceptives and the use of SARC was almost twice that of long-term methods. Increased access to contraception education for all women of reproductive age could significantly improve the use of long-term methods which offer more reliable protection against unintended pregnancies. The findings shed light on the need to strengthen both general and sexuality education to girls and women and to tailor contraception access for all in need, for mobile semi-urban as well as rural women. Well-informed strategies that engage young men and male partners in informed decision-making for contraceptive use could enhance progress.</div

pgph.0002688.t001 - Prevalence and predictors of use of long-term and short-acting reversible contraceptives among women of reproductive age in Wakiso and Hoima districts, Uganda: A cross-sectional study

pgph.0002688.t001 - Prevalence and predictors of use of long-term and short-acting reversible contraceptives among women of reproductive age in Wakiso and Hoima districts, Uganda: A cross-sectional study</p

Forest plot summary of model 3 (Table 2) showing relative risk ratios (RRR 95%CI) for the associations between independent variables and contraceptive use across SARC and long-term methods in Wakiso and Hoima districts in Uganda, 2020.

Forest plot summary of model 3 (Table 2) showing relative risk ratios (RRR 95%CI) for the associations between independent variables and contraceptive use across SARC and long-term methods in Wakiso and Hoima districts in Uganda, 2020.</p

Dataset.

Modern contraceptive use has increased globally, but unmet needs persist in low- and middle-income countries. This study in Uganda aimed to examine the prevalence and factors influencing the use of short-acting reversible contraceptives (SARC) like pills and long-term methods such as intrauterine devices. Limited evidence exists on the use of SARC and long-term methods in Uganda. Data from the Africa Medical and Behavioural Sciences Organization (AMBSO) Population Health Surveillance (APHS) in Hoima and Wakiso districts were analysed. Among the 1642 women aged 15–49 years, the prevalence of modern contraceptive use was 30% for SARC, and 18% for long-term method. Women with formal education were three times more likely to use long-term methods than those without formal education, relative risk ratios (RRR), 3.1–3.4, (95%CI 1.2–8.2). Joint decision-making for contraceptive use increased SARC usage, RRR 1.4 (95%CI 1.1–1.8). Urbanization played a role, with women in more urbanized Wakiso district less likely to use any modern contraception, RRR 0.6–0.7 (95%CI 0.5–0.9) compared to those living in the less urbanized Hoima. About half of the women in the study used modern contraceptives and the use of SARC was almost twice that of long-term methods. Increased access to contraception education for all women of reproductive age could significantly improve the use of long-term methods which offer more reliable protection against unintended pregnancies. The findings shed light on the need to strengthen both general and sexuality education to girls and women and to tailor contraception access for all in need, for mobile semi-urban as well as rural women. Well-informed strategies that engage young men and male partners in informed decision-making for contraceptive use could enhance progress.</div

Distribution of socio-demographic characteristics, sexual activity, and decision-making variables by type of contraceptive use among 1635 women in Wakiso and Hoima districts in Uganda in 2020.

Distribution of socio-demographic characteristics, sexual activity, and decision-making variables by type of contraceptive use among 1635 women in Wakiso and Hoima districts in Uganda in 2020.</p

Number and proportions of women using long-term, SARC, traditional contraception methods and non-users in Wakiso and Hoima districts in Uganda, 2020.

Number and proportions of women using long-term, SARC, traditional contraception methods and non-users in Wakiso and Hoima districts in Uganda, 2020.</p