The Economic and Social Impact of Informal Caregivers at Mulago National Referral Hospital, Kampala, Uganda

BackgroundThe severe deficit of health care workers in Uganda necessitates hospitalized patients to be cared for by a relative. These informal caregivers constitute a crucial component of patient care. Mulago Hospital in Kampala, Uganda, is one of the nation's national referral hospitals, receiving very sick patients. Although studies have been conducted on challenges facing informal caregivers in the home setting, no study has addressed the caregiver burden in the hospital setting.MethodsA survey of 100 randomly selected informal caregivers was conducted in Mulago Hospital's internal medicine wards to evaluate informal caregivers' demographics, impact on patient care, and challenges.ResultsChallenges include emotional burdens, lack of sanitation, accommodation, sufficient health workers, finances, and recognition. Recommendations were given to ensure improve informal caregivers' situations.ConclusionsDespite hardships, informal caregivers recognize the importance of familial presence, thereby setting a new standard for patient care by recreating the comfort of home care in the hospital. Studying the characteristics of these care givers and more fully delineating the sacrifices they make and the challenges they faced provides the basis for a series of recommendations to hospital management aimed both at improved patient care and care of the informal caregiver

Knowledge and practices related to sexually transmitted infections among women of reproductive age living in Katanga slum, Kampala, Uganda.

Background: Sexually transmitted infections (STIs) still stand as one of the commonest health problems affecting women of reproductive age. The knowledge and practices of STIs, among susceptible populations such as women of reproductive age, living in slums like Katanga in Kampala Uganda need to be established. Methods: This was a cross- sectional study with 339 participants in Katanga slum. Data was collected using an interviewer administered questionnaire, entered and analysed using SPSS version 17.0. Data was summarized using frequencies for categorical data and medians for continuous data. Results: Majority of the participants (71.9%) were 6525years with a mean age of 28.0(SD \ub17.0) years. The commonest symptoms known to the participants were genital itching (60%) and genital rash (14.5%). Most mentioned multiple partners (63.7%) and unprotected sex (50.7%) as predisposing factors to STIs. Knowledge on methods of prevention was high (92.3%) however, 18.8% were found positive for STIs using the syndromic approach and 82% mentioned having suffered from STIs in the past 6 months more than once. Conclusion: Most participants did not know about the systemic effects of STIs to their health and did not follow the appropriate behavior patterns despite being knowledgeable about the various methods of prevention of STIs

Knowledge and practices related to sexually transmitted infections among women of reproductive age living in Katanga slum, Kampala, Uganda

BACKGROUND: Sexually transmitted infections (STIs) still stand as one of the commonest health problems affecting women of reproductive age. The knowledge and practices of STIs, among susceptible populations such as women of reproductive age, living in slums like Katanga in Kampala Uganda need to be established. METHODS: This was a cross-sectional study with 339 participants in Katanga slum. Data was collected using an interviewer administered questionnaire, entered and analysed using SPSS version 17.0. Data was summarized using frequencies for categorical data and medians for continuous data. RESULTS: Majority of the participants (71.9%) were ≥25years with a mean age of 28.0(SD ±7.0) years. The commonest symptoms known to the participants were genital itching (60%) and genital rash (14.5%). Most mentioned multiple partners (63.7%) and unprotected sex (50.7%) as predisposing factors to STIs. Knowledge on methods of prevention was high (92.3%) however, 18.8% were found positive for STIs using the syndromic approach and 82% mentioned having suffered from STIs in the past 6 months more than once. CONCLUSION: Most participants did not know about the systemic effects of STIs to their health and didnot follow the appropriate behavior patterns despite being knowledgeable about the various methods of prevention of STIs

Incidence and Factors Associated with Postpartum Anemia at Mbarara Regional Referral Hospital

Background: The World Health organization defines postpartum anemia as hemoglobin <11g/dl at 1 week postpartum and <12g/dl at 8 weeks postpartum. Postpartum anemia can also be defined as less than 11.8 g/dl for women aged 12–15 years and less than 12g/dl for women at least age 15 years. In Uganda, 23% of women age 15-49 are anemic, with 18 percent having mild anemia, 5 percent having moderate anemia, and less than 1 percent having severe anemia. Objective: To determine the incidence and factors associated with the new cases of post natal anemia in Mbarara Regional Referral Hospital. Methods:  A prospective cohort study of 271 postpartum mothers without anemia enrolled on discharge after delivery. Participants were followed up to determine development of anemia at 10 weeks postpartum and associated factors on the subsequent postnatal visits. Incidence of postpartum anemia in MRRH was 29.9%, 95% CI (24 - 35). Helminthes infestations AOR95%CI; 12.88(5.25- 31.64, P<0.000), malaria infections AOR95%CI 4.74(1.50-14.94, P=0.008), poor hematinic adherence AOR95%CI, 6.81(3.17-14.62, P<0.000), high parity AOR95%CI, 2.48(1.11- 5.54, P=0.026), and husband unemployment AOR 3.92(1.14 – 13.39, P=0.030) were found to be statistically associated with post-partum anemia. Conclusion: The incidence of postpartum anemia in Mbarara Regional Referral Hospital is very high. Hematinics non adherence, husband unemployment, increased parity; malaria infection and helminthes infestation were found to be associated with post-partum anemia at MRRH

Experiences of faculty and students regarding a locally developed framework for implementing interprofessional education during international electives in Sub-Saharan Africa

Abstract Background Given that there are hardly any comprehensive frameworks to guide institutions on approaches to use as they implement interprofessional education and collaborative practice during international electives, we developed and piloted a framework to address this gap. The purpose of this study, therefore, was to explore the experiences of faculty and students regarding the use of the developed interprofessional education and collaborative practice framework during international electives. Methods This was an exploratory qualitative study. The study participants included faculty and students from four health training universities in Africa who participated in the pilot of international electives guided by the framework developed. Deductive thematic analysis was used to analyze the data. The codes were categorized as per the major themes. Results The major themes regarding the framework included (1) The Strengths, (2) Weaknesses, (3) Opportunities, and (4) Threats. All participants perceived the framework as useful and appropriate to enable the acquisition of interprofessional education and collaborative practice skills objectives set. The framework’s duration of the elective was seen as a weakness with the need for an increment in the duration. The opportunities the framework presented included: acting as a starting point to structure and implement interprofessional education across various training institutions in Africa, advancing research, and networking opportunities to share the best practices. The main threat included siloed training where the current training curriculum of the students does not have opportunities that allow the students to study with, from, and about each other. Conclusions The framework developed to guide the implementation of interprofessional education and collaborative practice during international electives is feasible and enabled students to achieve the interprofessional education and collaborative practice objectives set while appreciating the transcultural similarities and differences in another country

Sociodemographic Characteristics and Health Profile of the Elderly Seeking Health Care in Kampala, Uganda

Aging entails health challenges globally, but pertinent data from low-income countries like Uganda remains scarce. A cross-sectional study was carried out at Mulago National Referral Hospital in Kampala, among 134 patients (38% men and 62% women) aged ≥60 years. Data was collected on sociodemographic characteristics, medical disorders, cognitive function, hearing handicap, and functional status, that is, Basic Activities of Daily Living (BADL) and Instrumental Activities of Daily Living (IADL). The participants had high independency in BADL (89%) and IADL (75%). The most common medical conditions were bone/joint pain (35%), hypertension (24%), and visual problems (20%). More women (54%) than men (37%) reported bone and joint pain. The majority (80%) of the participants did not report any hearing handicap, and half (54%) did not have any cognitive impairment. Dependency in IADL was associated with advanced age, being female, and being financially dependent, and the risk of having a hearing handicap was higher among those above the median age (68 years). In adjusted models, the effects remained similar although statistical significance was only achieved for advanced age versus dependency in IADL (RR: 2.38, 95% CI: 1.12–5.08) and hearing handicap (RR: 2.67, 95% CI: 1.17–6.12). Thus, socioeconomic status and gender are relevant aspects when attempting to understand the health profile of the elderly in Kampala, Uganda

An exploration of faculty perspectives towards interprofessional education and collaborative practice during international electives in health professions training institutions in Africa

# Background Faculty perspectives are key drivers of learning during international electives (IEs). However, in Africa, there is limited literature on these perspectives on interprofessional education and collaborative practice (IPECP) during IEs. Therefore, this study explored faculty perspectives toward IPECP within an international elective context from selected African institutions. # Methods This was an exploratory qualitative study. The study participants included faculty from four health professional training universities in Africa. Thematic analysis was used to analyze the data. Common codes were identified and grouped to create subthemes and major themes. # Results Four themes were identified: (i) The importance of IPECP during IEs, (ii) Approaches to IPECP during IEs, (iii) Perceived key barriers, and (iv) Perceived institutional support for IPECP during IEs. Most of the participants perceived IEs as a platform that can be used to cultivate IPECP with a multicultural perspective while promoting cross-border partnerships to advance health care. Suggested teaching approaches included case studies, joint clinical ward rounds, and simulations, among others, with an openness to having an online, blended, or physical mode of delivery. A framework to guide the implementation of IPECP during IEs was considered important, and most participants thought that their institutions had the infrastructure to support IPECP-IEs. # Conclusions Faculty reported enabling perspectives of IPECP during IEs, emphasizing the need for a framework to guide and structure implementation. IPECP-IEs were perceived as a unique platform to cultivate IPECP skills with a multicultural component