Missed Opportunity for Neonates to Live: A Cross-Sectional study on Utilization of Peri-Natal Death Audits to address the Causes of Peri-Natal Mortality in District Hospitals of East–Central Uganda.

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

Malaria treatment health seeking behaviors among international students at the University of Ghana Legon.

IntroductionAppropriate management of malaria demands early health seeking behaviour upon suspicion of malaria-like symptoms. This study examined malaria treatment seeking behaviour and associated factors among international students at University of Ghana.MethodsThe study used a cross-sectional and quantitative approach. Data collection was undertaken using a structured questionnaire administered on a random sample of 264 international students. Data obtained on malaria treatment and factors influencing treatment behaviors were analyzed using IBM, SPSS Statistics version 22. Associations between individual characteristics and Malaria treatment seeking behavior was assessed by Pearson Chi-square(X2) test of independence. Binary logistic regression model was built using a backwards Wald approach, with variables retained at Wald p-value ResultsThe findings show that 35% of the respondents obtained self-prescribed antimalarial at their utmost first choice of Malaria treatment. At bivariate level, a significant relationship between Malaria health-care seeking behaviour and:- Respondents continent, X2(1, N = 264) = 7.936, p = .005; Service accessibility, X2(1, N = 264) = 7.624, p = .006; Wait time, X2(1, N = 264) = 22.514, p ConclusionThere were widespread inappropriate health-care seeking behavior for Malaria treatment among international students. Improving accessibility to malaria treatment services, reducing wait time at health facilities and the treatment cost will address inappropriate malaria treatment health seeking behaviours among the international students

The socio-economic and psychosocial impact of Covid-19 pandemic on urban refugees in Uganda

Considering the COVID-19 global public health crisis, this paper examines the socio-cultural, economic and psychosocial impact of the pandemic on urban refugees in Uganda. We analyse the living conditions of urban refugees that make it problematic for them to adhere to public health measures. Since COVID-19 is perceived as “imported”, refugees are assumed as its potential transmitters, consequently experiencing heightened stigma and isolation. Lack of culturally and linguistically accessible information and services excludes them from on-going efforts to prevent the pandemic. The lockdown has affected refugee livelihoods and increased income insecurity, sexual and gender-based violence and anxiety. Given the paucity of government-led services to contain the epidemic, we argue that contingency planning must involve refugees and their communities to access accurate and relevant information in appropriate languages. It is also important to build the capacity of frontline workers to understand the specific needs of refugees to deliver appropriate protection in the context of the pandemic

Access to HIV/AIDS or TB care among refugees in Kampala, Uganda: exploring the enablers and barriers during the COVID-19 pandemic

The rapid spread of COVID-19 has overwhelmed the existing health care systems, finding it challenging to provide essential health services besides the COVID-19 response interventions. Refugees are disproportionately affected by the COVID-19 pandemic because of the barriers they face to access health care. However, there is limited research that investigates how access to HIV/AIDS or TB care services by urban refugees is affected during pandemics such as the COVID-19. This study adopted a cross-sectional survey utilizing quantitative (N=229) and qualitative data (26 in-depth interviews and 8 key informant interviews) held among urban refugees living in Kampala, Uganda. Results revealed that more females (75%) than males (25%) were able to access TB or HIV/AIDS services during COVID-19 related lockdowns. A decrease in queues, delivery of drugs through Village Health Teams (VHTs), proximity to health facilities, supply of necessities like food and the reception at the health facilities facilitated access to TB or HIV/AIDS services. On the other hand, restrictions on public transport, high transport costs, unemployment and subsequent poverty were barriers to access to TB or HIV/AIDS services. Results offer major insights into the effect of COVID-19 control measures on disruption of access to services particularly in relation to being able to access service points. The findings suggest that recognizing structural barriers to uninterrupted or continued access to HIV/AIDS or TB services during pandemics such as COVID-19 can go a long way in helping stakeholders to design measures that make it possible for more urban refugees to access HIV/AIDS or TB services