FACTORS CONTRIBUTING TO NON-ADHERENCE TO ANTI-DIABETIC MEDICATION AMONG DIABETIC PATIENTS ATTENDING NDEJJE HEALTH CENTRE IV, WAKISO DISTRICT. A CROSS-SECTIONAL STUDY.

Background: The prevalence of Non-adherence to anti-diabetic medication is on the rise across the world. The purpose of this study was to find out the factors contributing to non-adherence to anti-diabetic medication among patients attending Ndejje Health Centre IV, Wakiso district. Methodology: A cross-sectional research design was used on diabetic patients aged 18-88 years, selected using a simple random sampling method and questionnaires to collect data which was analyzed using Microsoft Excel, and the results were presented as tables, graphs, and pie charts. Results: The majority 99.1% had type 2 diabetes mellitus and 57.3% had the disease for less than five years 90.4% reported hypertension as the most experienced comorbidity. 87% reported diabetic neuropathy as the most common complication. The reasons for non-adherence were; drugs being expensive (25%), not understanding the prescriptions (17.5%), and unavailability of anti-diabetics (16%). Conclusion: In conclusion, even though the majority of the respondents were adherent to their anti-diabetic medication, 34.3% were non-adherent, and they mentioned drugs being expensive as the biggest reason for this. Recommendations: Therefore, the researcher recommends the Ministry of Health ensure that drugs are available at health facilities and prescribers should explain the use, effects, and why these drugs are essential to patients

KNOWLEDGE, ATTITUDE AND PRACTICES TOWARDS UTILIZATION OF EMERGENCY CONTRACEPTIVES AMONG FEMALE YOUTH AT NDEJJE HEALTH CENTRE IV, WAKISO DISTRICT. A DESCRIPTIVE CROSS-SECTION STUDY.

Background. The study aimed to find out the knowledge, attitude, and practices towards the utilization of emergency contraceptives among female youth. Methodology. The study used a cross-sectional study design with a simple random technique as a sampling technique on a sample of 50 respondents. Data was collected using questionnaires and semi-structured questionnaires; data was later analyzed manually systematically by compiling it in the form of percentage bar graphs, tables, and pie charts. Results. Findings from knowledge show that (88%) of the participants had ever heard about emergency contraceptives, (50%) obtained information about emergency contraceptives from the health facility, (82%) knew pills as the type of emergency contraceptive, (64%) knew after un- protected sex as the indicator of EC’s (84%) knew one dose as the recommended dose, (72%) knew within 72 hours as the recommended intervals and (44%) knew pharmacies as the places where they can obtain EC’s. Attitude towards utilization of EC’s was shown that (60%) of the respondents agreed that the effectiveness of emergency contraceptives in preventing unwanted pregnancies was high, (54%) agreed that emergency contraceptives should be availed to female youth, (74%) were willing to use emergency contraceptives if the need arises. The practices towards utilization of EC showed that (70%) were sexually active (82%) had ever used emergency contraceptives mostly once in a while as noted by (90%), (80%) had used pills as the emergency contraceptive method they had ever used and (39%) had never used emergency contraceptives because of sexual partner’s disapproval. Conclusion. Female youth possessed fairly suitable knowledge, attitudes, and practices toward emergency contraceptives though an infrequent percentage number of participants. Recommendations. Ndejje Health Centre IV administration should carry out extensive education and communication programs through community outreaches in areas where female youth are easily accessible to address many misconceptions and myths about emergency contraceptives

Assessing Knowledge and Practices of the Community towards Corona Virus Disease 2019 in Mbale Municipality, Uganda: Across Section Study

Background: The Corona virus disease, first identified in Wuhan city, Hubei province of China, is a respiratory illness caused by Novel  Corona Virus also known as Severe Acute Respiratory Syndrome Corona Virus 2 (SARS Cov.2). The disease is characterised by; dry cough and shortness of breath with difficulty in breathing and at least 2 of the following; fever, chills, muscle pain, headache, sore throat and loss of test and smell. Uganda in general and Mbale in particular has people of diverse culture, religion and ethnic background as well as diverse socio economic activities with various practices. This multi-cultural environment creates differences in perception of information and practices. Most cultures encourage socialisation through social functions like attending weddings, funerals, work places and  gatherings and Muslims who have to go for congregation prayers in the mosques 5 times a day among others. This puts such communities at risk of spreading the disease very fast and slow in adapting to control measures Aim: In this study, we aimed at assessing knowledge and practices of the community towards COVID 19 in Mbale municipality. Methods and Materials: A cross section study was used; Data was obtained using a Questionnaires to a sample of 355 respondents and an observation tool was also used to observe behaviour patterns and practices of 776 participants towards the control measures of COVID-19. Results: There was a total of 355 respondents with 208 /355 (58.59%) male and 147/355 (41.4%) female. 149/355(42%) possessed good  knowledge, 131/355(36.9%) had moderate knowledge and 75/355(21%) had a little knowledge on COVID-19. Participants who were single and aged between 21-30 years were found to be more knowledgeable than other groups (P value=.001 and P value=.003 respectively).The source of COVID 19 information was mainly from television and radios 124/248 (50%) and social media 34/248 (21.8%) and the least source of information being 14/248(5.6%) and 9/248(3.6%) from health workers and Religious leaders respectively. 496/776 (64%) of the  respondents observed, washed their hands and only124/776 (16%) of the respondents wore face masks. 98/776 (12.6%) were seen shaking hands and 15/776(2%) were seen hugging. Conclusion: Use of appropriate and well-designed Health education materials on radios, televisions and social media platforms like Facebook and twitter among others can be effective means of communication since they can reach the highest number of people. Ministry of Health should design ways for systematically integrating both political and religious leaders in Health Education Campaigns.  Government should provide facemasks and enforce their use. A study to assess the ability of both political and religious leaders in health promotion campaigns should be carried out

Addressing gaps in AMR awareness in the public: an evidence-based policy brief to guide school curriculum review in Uganda

The government of Uganda, through its Ministry of Health, previously adopted curriculum review as a mechanism to respond to public health threats such as HIV/AIDS and include content in primary and secondary schools. This approach contributes to raising public awareness, a key strategy recommended by the World Health Organization to support the global response to the threat of antimicrobial resistance (AMR). This policy brief, developed for policymakers related to school curricula, aims to advocate for and support integration of AMR content in Uganda's primary and secondary level school curricula. The policy brief supports efforts by the multisectoral National AMR Subcommittee to create awareness on this issue as part of its role in facilitating the operationalization of Uganda's National Action Plan on AMR

What is the appropriate antimicrobial use surveillance tool at the health facility level for Uganda and other low- and middle-income countries?

ABSTRACT: Background: An appropriate antimicrobial use (AMU) surveillance system provides critical data and evidence on which antimicrobial stewardship interventions are based. However, Uganda and most other low- and middle-income countries (LMICs) lack efficient systems for monitoring AMU due to unique health system challenges. Methods: We reviewed the key tools available for AMU surveillance in health facilities. Based on our implementation experience, we present arguments on the need for country authorities to adapt a customized and standardized tool for national uses. Results: Despite ongoing efforts to set up AMU surveillance programs in Uganda, AMU data remain sparse, with most of the available data collected through antimicrobial stewardship related continuous quality improvement efforts implemented by global AMR control programs. There is variability in the interpretation of available AMU surveillance tools and a need to identify the most appropriate AMU surveillance methodologies and tools for Uganda and other LMICs. Data fields for sex and gender are incorrectly categorized and there is no tool that records pregnancy variable. Based on the past four years of practical implementation experience since the launch of the World Health Organization's Point Prevalence Survey methodology in 2018 for inpatient settings, we believe that the tool should be modified in cognizance of existing capacity and priorities in resource-constrained settings. Conclusions: The World Health Organization, regional experts, ministry of health authorities, and other stakeholders should urgently review available tools with a view to adopting a customized and standardized facility AMU surveillance methodology suitable for national-level rollout in LMICs

A One Health approach to fight antimicrobial resistance in Uganda: Implementation experience, results, and lessons learned

Uganda has been implementing the Global Health Security Agenda (GHSA) since 2015 to build its capacity according to World Health Organization (WHO) Benchmarks on International Health Regulations Capacities. The country remains prone to outbreaks, with more than 20 disease outbreaks reported in the past five years, including Ebola virus disease, Crimean-Congo haemorrhagic fever, Marburg haemorrhagic fever, measles, yellow fever, coronavirus disease 2019 (COVID-19), and cholera. Antimicrobial resistance (AMR) is an ongoing challenge. Uganda scored capacity level 3 on infection prevention and control (IPC) and antimicrobial stewardship (AMS) in the 2017 Joint External Evaluation (JEE) assessment. Identified gaps were being addressed after a self-assessment in 2021. This paper describes the technical assistance approaches provided to Uganda by the Medicines, Technologies, and Pharmaceutical Services Program, funded by the United States (U.S.) Agency for International Development, and implemented by Management Sciences for Health. The program, through a One Health approach, supported systematic capacity strengthening based on the JEE’s capacity advancement framework for global health security, specifically relating to AMR. The program’s interventions impacted 32 WHO benchmark actions (7 for AMR multisectoral coordination, 16 for IPC, and 9 for AMS), contributing to Uganda’s strengthened GHSA capacity. Leveraging success built on the AMR platform, the program trained 745 health workers in IPC for the Ebola virus and provided support for simulation exercises by eight district IPC teams. The program also worked with the Ministry of Health to coordinate IPC for the COVID-19 response in five health regions, covering 45 districts and reaching 5,452 health workers at 858 health facilities