Factors influencing utilisation of postnatal services in Kampala, Uganda

BACKGROUND: Maternal, child-health and health education are three major concerns of public health organizations and researchers throughout the world. Over half a million women encounter complications due to childbirth annually and many even die. Health education for mothers is thus a strategy many countries have adopted to improve maternal and child-health. OBJECTIVES: This study investigated possible factors influencing the use of postnatal services at two hospitals in Kampala- Uganda. STUDY DESIGN: A cross-sectional survey was completed by a convenient sample of women. METHODS: A structured questionnaire was administered to three hundred and thirty (330) women six to eight weeks after delivery. The participants were selected from a list of all women who delivered in two hospitals in Kampala, Uganda. RESULTS: The main barriers to utilisation of postnatal services identified were lack of awareness about postnatal services, distance from hospitals and lack of somebody to take care of the children at home. CONCLUSIONS: The results from this study reinforce the need for education of women and the communities about the importance of postnatal care

Exploring and curbing the effects of HIV/AIDS on elderly people in Uganda

Introduction: This paper presents HIV/AIDS experiences of elderly persons in Uganda as revealed by an ongoing descriptive cross-sectional study covering eight districts, namely: Pallisa, Kampala, Jinja, Lira, Nebbi, Ntungamo, Luwero and Mbarara. These districts represent both the rural and urban areas of the four regions of Uganda, including: Western, Northern, Eastern and Central region. Methods: The study employed a mixed method approach using a sequential exploratory strategy. Data was collected using not only focus group discussions and in-depth interviews held with 165 elderly persons but also a validated interview schedule administered to 50 key informants. Elderly persons participated in the study by providing data on their HIV/AIDS-related experiences. Key respondents were selected to provide data on strategies that could be adopted to curb the effects of the epidemic. This paper is based on one of the study's objectives, which focussed on exploring the effects of HIV/AIDS on Uganda's elderly people; coping mechanisms used to deal with HIV/AIDS; and strategies for curbing its effects. Data was analysed using content analysis and the descriptive method of SPSS. Results: Results show that HIV/AIDS affected most of the elderly people in Uganda by killing their children and spouses, and leaving them with a big burden of taking care of AIDS orphans; yet majority of these people were financially too incapacitated to shoulder it amply. HIV/AIDS also infected the elderly people. The epidemic introduced the need for ARVs and other health services that elderly people found too difficult to access due to poor health service delivery systems in Uganda. Most elderly people used food cultivation as a mechanism for coping with the burden of orphans. These results lead to recommending that government should economically empower elderly people through formulation and effective implementation of welfare policies regarding pension and special fund for these people. Conclusion: There is a need for the government to provide adequate and free HIV/AIDS-related health services and also increase educational support for HIV/AIDS orphans

Factors influencing utilisation of postnatal services in Mulago and Mengo Hospitals Kampala, Uganda

Magister Scientiae (Physiotherapy) - MSc(Physio)Maternal and child-health and health education are three major concerns of public health organisations and researchers throughout the world. Health education for mothers is a strategy many countries have adopted to improve maternal and child-health. The present study was carried out in Uganda with the objective of exploring the factors influencing the utilisation of postnatal services at Mulago and Mengo hospitals, a government and private hospital. Both hospitals are located in Kampala district in Uganda. The survey, was completed by 330 women who responded to a structured questionnaire that was given to them six to eight weeks after delivery. Questions that were asked generated demographic information about the mothers; mothers’ knowledge about postnatal services; mothers’ socio-economic status and barriers to utilisation of the postnatal services. The participants included all women who delivered in Mulago and Mengo hospitals in November 2003 except for those who had had a neonatal death. The data was analysed using descriptive and inferential statistics. Some of the key findings of the study were that most women lacked awareness about postnatal services and those who knew about these services only knew about immunisation and family planning services. The majority of the mothers did not know about other services, such as physiotherapy, counselling, growth monitoring, and physical examination. Lack of money for transport or service costs, distance from the health care facility, not being aware of the services, lack of somebody to take care of the child at home were some of the main barriers to utilisation of postnatal services. Others included, lack of education, lack of employment, lack of decision-making powers, and lack of time to go back for the service. The ministry of health should educate women and communities about the importance of postnatal care, its availability, and the importance of women having decision-making power over their own health. The health service organization should improve on the quality of care by ensuring that services are provided at convenient hours with privacy, confidentiality and respect and it should evaluate the services periodically from the users perspective to maintain the quality of service.South Afric

Exploration of needs, problems and living experiences of older persons in Uganda: implications for policy and decision making

Philosophiae Doctor - PhDThe purpose of the study was to explore the needs, problems and living experiences of the older persons in Uganda and their implications for decision making and policy. The study was an exploratory descriptive cross-sectional study that involved triangulation of both qualitative and quantitative approaches. It was guided by five objectives, which included: exploring the living experiences of Uganda' s older persons living in both rural and urban settings; identifying the barriers to these people's effective participation in society; establishing the mechanisms that they use to cope with the barriers; evaluating the extent to which their needs are addressed by policy; and proposing policy strategies needed to address their plight. The study sample consisted of two purposively selected sub samples of 165 older persons for qualitative data and 50 key informants for quantitative data. The key informants were selected from Ministries of Gender, Labour and Social Development; Urban, Housing and Physical Planning; Agriculture; Health; Education and Sports, Public service, and nongovernmental organizations dealing with the older persons in Uganda. Data were collected using in depth interviews with older persons, self administered questionnaire to key informants and documentary review. The qualitative data was analyzed using content analysis including documentary review, while the quantitative data was analysed using the frequency option of the descriptive method of SPSS, and graphical method of the Excel programme. Results show that the living experiences of most of Uganda's older persons are characterised by pathetic economic, health, social, housing and accommodation, water supply, and sanitation conditions. The barriers to the effective participation of these people in society take the form of age-related prejudices, problems, and limitations faced at personal, household and community levels. They basically include constraints to the physical fitness, healthcare, economic status, food security and nutrition, and realization of accommodation and housing conditions desired by these people to live a life by which they can effectively participate in society. Other barriers include: large numbers of grandchildren most of whom are orphans left behind by the older person's children claimed by the HIV/AIDS pandemic and community members ignoring them as helpless people who have outlived their usefulness. Accordingly, the coping mechanisms used by these people were established as the psychological, physical, healthcare, and economic ways by which they deal with each of the aforementioned barriers. A review of development policies such as PEAP, PMA, NAADS, HIV/AIDS policies among others revealed that a number of policies and programs in Uganda exclude the older persons from active participation. Findings show further that though the extent to which the Constitution of Uganda government recognizes the plight of the older persons is appreciable, it is largely insufficiently translated into policy action by which the plight can be effectively addressed. A number of strategies were therefore proposed to help address this insufficiency, thereby solving the needs and attending to the barriers facing these people in an effective policy manner. The strategies focused on improving older persons' physical fitness, access to healthcare, economic capacity, food security and nutrition, and housing and accommodation. Other strategies focused on dealing with the impacts of HIV/AIDS and community prejudices held against older persons. The study was concluded by observing that although the quality of the living experiences of Uganda's older persons can be improved by dealing with the barriers faced by these people, the mechanisms that they use to do so are not adequate. It was also noted that there was need to translate the constitutionally recognised plight of the older persons into effective policy action. Consequently, it was recommended that the proposed policy strategies should be adopted and translated into the needed policy action. Further research was also recommended into the legal implications and funding implications of the proposed policy strategies

The root cause for the exclusion of older persons from participation in developmental activities in the society - African perspective

This paper review the literature regarding the barriers to participation of older persons in the African society. Studies have shown that older persons are vulnerable and thus do not participate in most development programmes in society to improve their livelihoods. Research has further shown that there are factors that could be hindering their participation in society. This paper attempts to highlight some of the barriers that hinder participation of older persons in the African communities. The authors conclude that the barriers to effective participation of older persons in society include the state of older people's personal health, poverty and the negative and limiting community attitudes, laws and practices. Pensions, social grants and allowances are among the means through which the elderly cope. However not all older persons have access to pensions as the majority did not work in government. Furthermore, most countries in Africa except for a few such as Mauritius, Namibia, Mozambique, South Africa, Botswana and Lesotho have not considered giving their senior citizens social grants to improve on their livelihoods