Community readiness and acceptance for the implementation of a novel malaria vaccine among at-risk children in sub-saharan Africa: a systematic review protocol.

BACKGROUND: The World Health Organization novel malaria vaccine for at-risk children has the potential to greatly reduce the current malaria burden in sub-Saharan Africa. However, most studies have reported contradictory findings regarding community willingness for the vaccine, which could easily undermine the expected benefits of the vaccine. This study aims to ascertain the current state of community readiness and acceptance for the implementation of a novel malaria vaccine (RTS,S/ASO1) among at-risk children in sub-Saharan Africa, based on available evidence. METHODS: This study will follow the Preferred Reporting Items for Systematic Reviews and Meta-analyses protocol (PRISMA-P) guidelines. Relevant studies will be comprehensively searched from PubMed, ScienceDirect, Web of Science, Google Scholar, and African journals online, in accordance with the Cochrane search guidelines. Two independent reviewers will screen titles, abstracts and full texts of eligible studies based on some specified eligibility criteria. When it is feasible to conduct a meta-analysis, a random effects model will be employed to estimate the common effect due to anticipated high heterogeneity of the data. The effect measure for readiness or acceptance will be reported as a pooled proportion with corresponding 95% confidence interval. Additionally, odds ratios with 95% confidence interval will be estimated to assess factors associated with readiness. These will be presented on a forest plot. DISSEMINATION PLANS: The findings of the study will be peer-reviewed and published in a scientific journal. Conference presentations will also be made to the different stakeholders in the malaria vaccination campaigns. SYSTEMATIC REVIEW REGISTRATION: The protocol has been registered with PROSPERO Registration Number: CRD42023480528.

Access to family planning services and associated factors among young people in Lira city northern Uganda.

BACKGROUND: Access to family planning services among young people is crucial for reproductive health. This study explores the access and associated factors among young people in Lira City, Northern Uganda. METHODS AND MATERIALS: A mixed-methods study was conducted in March to April 2022. Quantitative data were collected using a structured questionnaire from 553 participants aged 15-24 years. Qualitative data were obtained through in-depth interviews and focus group discussions. Data analysis included univariate, bivariate, and multivariate analyses for quantitative data, while interpretative phenomenological analysis was used for qualitative data. RESULTS: Overall, 31.7% of the respondents had a good perceived access to family planning services, with 64.6% reporting perceived availability of FP methods. Challenges included lack of privacy (57.7%), fear of mistreatment (77.2%), and decision-making difficulties (66.2%). Among females, good perceived access to FP services was less likely among urban residents (AOR: 0.22, 95% CI: 0.09-0.53), Christian respondents (AOR: 0.51, 95% CI: 0.01-0.36), Muslim respondents (AOR: 0.07, 95% CI: 0.01-0.55) and respondents with poor attitude to FP services (AOR: 0.39, 95% CI: 0.24-0.64), but more likely among respondents with a sexual a partner (AOR: 4.48, 95% CI: 2.60-7.75). Among males, good perceived access to FP services was less likely among respondents living with parents (AOR: 0.19, 95% CI: 0.05-0.67) but more likely among respondents with good knowledge of FP services (AOR: 2.28, 95% CI: 1.02-5.32). Qualitative findings showed that three themes emerged; knowledge of family planning methods, beliefs about youth contraception and, friendliness of family planning services. CONCLUSION: The study revealed a substantial gap in perceived access to family planning services among young people in Lira City. Barriers include privacy concerns, fear of mistreatment, and decision-making difficulties. Tailored interventions addressing urban access, religious beliefs for females, and knowledge enhancement for males are essential. Positive aspects like diverse FP methods and physical accessibility provide a foundation for targeted interventions. Youth-friendly services, comprehensive sexual education, and further research are emphasized for a nuanced understanding and effective interventions in Northern Uganda.

The Lived Experiences of Individuals and Coping Strategies in the Context of Internet Gaming Disorder: A Qualitative Study Within Higher Education Setting in Uganda.

Background: Internet Gaming Disorder (IGD), recognized as a mental disorder in both the Diagnostic and Statistical Manual (DSM-5) and International Classification of Diseases (ICD-11), poses significant threats to physical, social, and mental well-being. This study aims to delve into the experiences of individuals grappling with IGD. Methods and Materials: The study employed an interpretive phenomenology, conducting interviews with 10 graduate students at Makerere University. Participants were purposefully sampled until data saturation was achieved during interviews, which took place between May and July 2023. An interview guide facilitated data collection (Supplementary File 1), and thematic analysis was manually applied for data interpretation, utilizing intuition and imaginative approaches. Results: The findings revealed that the majority of participants started gaming during childhood, starting with offline games. Exposure to gadgets and games, idle time, and stress emerged as key triggers for IGD. Participants reported experiencing sleep deficits, deteriorating interpersonal relationships, declining job performance, unhealthy eating habits, academic challenges, and wastage of money and time. The study also identified strategies employed by participants to mitigate their gaming behaviors, such as refraining from purchasing data, seeking support from friends, and uninstalling the game app, although relapses were common. Conclusion: The study highlights a global pattern of early initiation into gaming, emphasizing the need for early intervention and preventive measures. Factors such as easy accessibility and affordability of gaming platforms, idleness, and stress play significant roles in motivating internet gaming, contributing to a higher prevalence among the studied population. The research underscores the adverse effects of IGD on students, affecting academic performance, interpersonal relationships, and job performance. Notably, participants demonstrate agency in addressing IGD through practical coping strategies, including controlling data access, seeking social support, and uninstalling games. These coping mechanisms provide valuable insights into the complex nature of addressing IGD and form a basis for developing targeted interventions and support systems within the higher education setting in Uganda.

Prevalence of diarrhea and water sanitation and hygiene (WASH) associated factors among children under five years in Lira City Northern Uganda: Community based study.

BACKGROUND: Children under the age of five experience a significant disease burden from diarrheal illnesses. This poses a severe public health risk as the second leading cause of infant death worldwide, after pneumonia. Lira City in Uganda is one of the developing urban areas with limited information about the diarrheal disease among children under the age of 5 years. This study aimed to determine the prevalence and assess the water, sanitation and hygiene related factors associated with diarrheal diseases among children under five years in Lira City. METHODS: The study was conducted among 492 care takers of children under the age of 5 years in Lira City between August 2022 and September 2022. Data was collected using an interviewer administered questionnaire and a multi-stage sampling was used to select study participants. Data was analyzed by bivariate and multivariate logistic regression using STATA version 17. P-value of < 0.05 was considered statistically significant. RESULTS: Out of 541 participants, 492 responded. The majority of the respondents, 425(86.4%) were female, 146(29.7%) had children aged 1-12 months, 192 (39%) had primary level education, and 155(31.5%) were self-employed. The prevalence of diarrhea among children under five years was 130(26.4%) and the associated factors with diarrheal disease were children between 49-60 months old (AOR = 0.12, 95% CI: 0.03-0.39, P = 0.001), cleaning the latrine more times (AOR = 0.42, 95% CI: 0.22-0.81, P = 0.010) and not treating water (AOR = 1.84, 95% CI: 1.11-3.06, P = 0.018). CONCLUSION: There is high prevalence of diarrhea among children under 5 years of age. The study's findings highlight the need for ongoing efforts to lower the prevalence of diarrheal illnesses among children under the age of five in Uganda's emerging urban areas.

Systematic review and meta-analysis of postpartum depression and its associated factors among women before and after the COVID-19 pandemic in Uganda.

OBJECTIVE: This meta-analysis aimed to estimate the national prevalence of postpartum depression (PPD) in Uganda and identify predictors in both pre-COVID-19 and post-COVID-19 eras. DESIGN: Used a systematic review and meta-analysis methodology. DATA SOURCES: Reviewed papers were sourced from Medline/PubMed, PsycINFO, CINAHL/EBSCOhost, Google Scholar, ScienceDirect and African Journals Online. ELIGIBILITY CRITERIA FOR SELECTED STUDIES: The review encompassed observational studies published on PPD in Uganda from 1 January 2000 to 30 November 2023. RESULTS: 11 studies (involving 7564 participants) published from 1 January 2000 to 30 November 2023 were reviewed. The pooled prevalence of PPD in Uganda was 29% (95% CI 21% to 37%, I2=98.32%). Subgroup analysis indicated a similar prevalence before (29%, 95% CI 20% to 39%) and during (28%, 95% CI 22% to 32%) the COVID-19 period. Special groups exhibited a higher prevalence (32%, 95% CI 16% to 47%) than general postpartum women (28%, 95% CI 19% to 37%). Factors associated with PPD included poor social support (OR 1.19, 95% CI 1.17 to 1.22, I2=96.8%), maternal illness (OR 1.22, 95% CI 1.19 to 1.26, I2=96.9%), poor socioeconomic status (OR 1.43, 95% CI 1.40 to 1.46, I2=99.5%) and undergoing caesarean section (OR 1.15, 95% CI 1.12 to 1.17, I2=80.6%). Surprisingly, there was a marginal decrease in PPD during the COVID-19 period. Subgroup analysis highlighted a higher prevalence among mothers with HIV. CONCLUSION: This study underscores the significant prevalence of PPD in Uganda, with sociodemographic factors increasing risk. Despite a slight decrease during the COVID-19 period, the importance of prioritising maternal mental health is emphasised, considering sociodemographic factors and pandemic challenges, to improve maternal and child health outcomes and overall well-being.

Knowledge, Perception, and Practice of Safe Medical Circumcision on HIV Infection Risk Reduction among Undergraduate Students of a Public University in Northern Uganda: A Cross-Sectional Study.

Background: About 70% (25.6 million) of the global HIV/AIDS burden is from Sub-Saharan Africa. Safe male circumcision (SMC) is one of the measures that were adopted by the Ugandan government aimed at reducing the risk of HIV infection contraction, as recommended by the WHO. Its main goal was to maximize HIV prevention impact with voluntary medical circumcision services to all adult men and adolescent boys. The objective of our study was to assess the knowledge, perception, and practice of safe medical circumcision on HIV infection risk reduction among undergraduate students of a public university in Northern Uganda. Methods: We conducted a cross-sectional survey among 556 randomly selected Lira University undergraduate students from March 2023 to June 2023. With the use of a self-administered questionnaire, we collected data on the knowledge and perceptions of undergraduate students towards safe medical circumcision. Data were exported to Stata® 17 statistical software. Univariate, bivariate, and multivariate regression analyses were done at a statistical level of significance P value < 0.05. Results: Our 556 study participants had an age range of 21-25 years. The majority (81.29%) of the respondents knew that safe medical circumcision reduces the risk of acquiring HIV. However, the perception is that close to 3 in 4 (74.46%) of the students were unsure if they would opt for safe medical circumcision as risk reduction measure against HIV. The practice of safe medical circumcision was 64.8% among the study participants. Conclusions: More than three in four of the undergraduate students have knowledge on safe medical circumcision as risk reduction measure for HIV infection. And close to 3 in 4 (74.46%) of the student's perception were unsure if they would opt for safe medical circumcision as risk reduction measure against HIV. The practice of safe medical circumcision was 64.8% among the study participants. Therefore, in an effort to increase SMC's adoption for HIV/AIDS prevention, the Ministry of Health of Uganda and related stakeholders in health should work hand in hand with university study bodies in order to optimize SMC uptake among university students.

Exploring Effective Approaches: Integrating Mental Health Services into HIV Clinics in Northern Uganda.

Background: Integrating mental health services into HIV clinics is recognized as a promising strategy. However, the literature reveals gaps, particularly in the unique context of Northern Uganda, where factors such as historical conflict, stigma, and limited resources pose potential barriers. Material and Methods: This qualitative study, conducted between October and November 2023, employed a phenomenological design. The study involved primary healthcare facilities across diverse urban and rural settings, focusing on healthcare providers, village health teams, and service users. A purposive sampling approach ensured diverse demographics and perspectives. In-depth interviews and focus group discussions were conducted, with healthcare providers and service users participating individually, and village health teams engaged in group discussions. Thematic analysis was employed during data analysis. Results: Findings revealed a predominance of females among healthcare providers (18 of 30) and service users (16 of 25), as well as in VHTs. Average ages were 33.4 (healthcare providers), 38.5 (service users), and 35.1 (VHTs). Most healthcare providers (15) held diplomas, while 12 service users and 4 VHTs had certificates. The majority of healthcare providers (n=20) and 4 VHTs had 6-10 years of experience. Thematic analysis highlighted three key themes: benefits of integrated mental health services, implementation challenges, and the role of community engagement and cultural sensitivity. Conclusion: This study contributes valuable insights into the integration of mental health services into HIV clinics in Northern Uganda. The perceived benefits, challenges, and importance of cultural sensitivity and community engagement should guide future interventions, fostering a holistic approach that enhances the overall well-being of individuals living with HIV/AIDS in the region. Policymakers can use this information to advocate for resource allocation, training programs, and policy changes that support the integration of mental health services into HIV clinics in a way that addresses the identified challenges.

A systematic review and meta-analysis of compassion fatigue among healthcare professionals before and during COVID-19 in Sub-Saharan Africa.

Compassion fatigue is a significant concern globally, particularly in Sub-Saharan Africa, where the COVID-19 pandemic exacerbated existing challenges, placing unprecedented strain on healthcare professionals. This study systematically estimated the prevalence of compassion fatigue among healthcare professionals before and during COVID-19 in Sub-Saharan Africa. A systematic review was conducted using keywords in PubMed, ScienceDirect, Google Scholar, and grey literature, covering all literature published between 2012 and December 30, 2023. The search team independently conducted study selection, quality assessments, data extractions, and analysis of all included studies. The systematic review, reported following PRISMA guidelines, included 11 studies. The results show that the pooled overall prevalence of compassion fatigue in Sub-Saharan Africa was 70% (95% CI: 57-82, I2 = 88.37%). The highest prevalence was found in Eastern Africa at 74% (95% CI: 55-93, I2 = 94.40%), compared to 64% in Southern Africa (95% CI: 49-79, I2 = 59.01%). Nurses reported the highest rates of compassion fatigue at 80% (95% CI: 57-100, I2 = 34.77%), followed by general healthcare professionals at 59% (95% CI: 22-97, I2 = 94.11%) and nursing students at 50% (95% CI: 35-64, I2 = 0.00%). Before COVID-19, the overall prevalence of compassion fatigue was 66% (95% CI: 41-91, I2 = 27%). During COVID-19, this increased to 74% (95% CI: 63-85, I2 = 88.73%). Our results indicate that nearly 3 in 4 healthcare professionals in Sub-Saharan Africa experience compassion fatigue, and this prevalence increased due to the pandemic. The high prevalence underscores the importance of addressing and mitigating compassion fatigue to support the mental health and emotional well-being of healthcare professionals dedicated to helping others in challenging circumstances. Systematic registration: PROSPERO. REG No: CRD42023449462.

Qualitative study on stigma as a barrier to emergency contraceptive pill use among university students in the Lango subregion, Uganda.

OBJECTIVE: The aim of the current study was twofold: to understand the nature and extent of stigma and to learn the reasons behind the decision not to use emergency contraceptive pills among university students in the Lango subregion of Uganda. DESIGN: An exploratory qualitative study design. SETTING: The study was carried out among university students in Lango subregion of Uganda. PARTICIPANTS: 40 female university students across four universities. MAIN OUTCOME MEASURES: Stigma. RESULTS: Participants (n=40) aged 19-26 exhibited generally positive attitudes towards emergency contraceptive pills, recognising them as empowering and essential. Stigma, however, emerged as a substantial barrier manifested in societal judgements and negative perceptions. Themes included the positive attitude towards emergency contraceptive pills, perceptions of peers and the general public, and perceptions of health service providers. CONCLUSION: Stigma significantly impedes emergency contraceptive pill use among university students in the Lango subregion, Uganda. Positive attitudes towards the pills contrast with societal judgements and provider stigmatisation. Tailored interventions addressing knowledge gaps, societal perceptions and healthcare system challenges are crucial for improving emergency contraceptive pill acceptability and utilisation among university students.

HIV-Related Stigma Among Pregnant Adolescents: A Qualitative Study of Patient Perspectives in Southwestern Uganda.

Background: The HIV epidemic disproportionately affects adolescents in Sub-Saharan Africa, with adolescent girls facing heightened vulnerability. Despite advancements in antiretroviral therapy, HIV-related stigma remains prevalent, particularly among pregnant adolescents. This qualitative study explores the perspectives of adolescents living with HIV in southwestern Uganda, seeking to understand the nature of HIV-related stigma in this context. Methods: One-on-one narrative interviews were conducted with 28 pregnant adolescents living with HIV aged 14-19 receiving care at Mbarara Regional Referral Hospital. The qualitative approach allowed for in-depth exploration of participants' experiences. Thematic analysis was employed to identify recurring patterns in the narratives. Results: Five overarching themes emerged from the analysis: Experiences of double stigma, social and cultural influences shaping stigma, healthcare system challenges, psychosocial impacts of stigma, and resilience and coping mechanisms. Double stigma, arising from societal prejudices related to both HIV status and teenage pregnancy, created a complex environment for participants. Despite these challenges, participants exhibited resilience through external support and internal strength. Conclusion: This study reveals the pervasive double stigma experienced by pregnant adolescents living with HIV in southwestern Uganda, driven by societal biases against both HIV status and teenage pregnancy. Urgent targeted interventions are needed to address the intersectionality of stigma, cultural influences, healthcare issues, and psychosocial well-being for the betterment of this vulnerable population.

Burnout and coping mechanisms among healthcare professionals in central Uganda.

Background: The escalating global prevalence of burnout among healthcare professionals poses a serious health concern. Recent studies focus on prevalence and predictors of burnout among healthcare providers, emphasizing the need for well-being interventions. This study investigates burnout and coping mechanisms among healthcare professionals in central Uganda, addressing the dearth of knowledge about coping strategies specific to the region. Methods: An analytical facility cross-sectional study was conducted in five healthcare facilities in central Uganda between June to July 2023. Participants included physicians, nurses, and technicians actively engaged in direct patient care. Data were collected using socio-demographic surveys, the Professional Quality of Life (ProQOL-5), and the Brief-COPE tools. Results: The study revealed a high prevalence of burnout, with 39.8% of participants experiencing significant levels. Active coping, positive reframing, and denial were negatively correlated with low burnout levels. Dysfunctional coping, specifically self-distraction and denial, showed positive correlations with average and high burnout levels. Emotion-focused coping mechanisms were not employed across burnout levels. Conclusions: The results emphasize the demanding nature of healthcare roles in the region and highlight the need for comprehensive, context-specific interventions to address burnout globally. While some healthcare professionals utilized adaptive strategies such as seeking social support, engaging in self-care activities, and utilizing problem-solving skills, others resorted to maladaptive coping mechanisms such as substance use and avoidance behaviors. This dichotomy highlights the need for targeted interventions to promote adaptive coping strategies and mitigate the negative impact of maladaptive behaviors on individual well-being and patient care.

Burnout and quality of life among healthcare workers in central Uganda.

BACKGROUND: The widespread problem of burnout among healthcare workers is not only common but also a significant concern that impacts the entire healthcare system in Uganda. It is essential to understand the connection between burnout and quality of life among healthcare workers in the specific context of central Uganda, where healthcare professionals face high patient volumes, limited resources, exposure to infectious diseases, and socioeconomic challenges. This study examined the relationship between burnout and quality of life among healthcare workers in central Uganda. METHODS: This research utilized a cross-sectional study conducted across various healthcare settings in central Uganda. The data were analyzed at descriptive, bivariate, and multivariate levels. The relationship between dependent and independent variables was evaluated using an independent t-test for binary variables and a one-way analysis of variance (ANOVA) for categorical variables. Significance was determined with a reported p-value, with relationships deemed significant at p < 0.2. For multivariable analysis, multiple linear regression was employed using a forward selection method, with significance set at 5% (p < 0.05). RESULTS: Our findings indicate that nearly 40% of healthcare workers reported experiencing high levels of burnout. The average score for overall quality of life was 10.71 (±4.89), with variations observed across different domains. The study reveals a significant connection between socio-demographic factors, burnout, and overall quality of life, emphasizing the impact of job category, supervisory support, sleep quality, and burnout on the well-being of healthcare workers. Predictive analysis illustrates how these factors influence both overall quality of life scores and scores in specific domains. Particularly noteworthy is that nurses and technicians tend to have a lower quality of life compared to physicians. CONCLUSION: The results underscore the relationship between socio-demographic factors, burnout, and particular aspects of quality of life. Notably, job category, supervisory support, sleep quality, and burnout stand out as significant factors shaping the well-being of healthcare workers. Nurses and technicians encounter distinct challenges, suggesting the need for interventions tailored to their needs. Addressing issues such as inadequate supervisory support, burnout, and sleep-related problems is recognized as a potential approach to improving the overall quality of life among healthcare workers.

An Analysis of Post-Traumatic Stress Disorder and Quality of Life Among Adults Living with HIV in Western Uganda.

Background: HIV/AIDS remains a significant global public health issue, profoundly impacting infected individuals. Living with HIV involves complex mental health dynamics, with post-traumatic stress disorder (PTSD) being a prevalent challenge. This study aims to examine the correlation between PTSD and quality of life among HIV-positive individuals in western Uganda. Material and Methods: Conducted between May and July 2023, this facility-based cross-sectional study surveyed 439 participants from four HIV clinics in southwestern Uganda. Data were collected through interviewer-administered questionnaires, analyzed using descriptive statistics, simple linear regression, and multiple linear regression (p<0.05). Results: Respondents had a mean age of 40.6 years, with 68.3% female, 54.9% married, and 55.1% lacking formal education. The reported PTSD prevalence among HIV-positive individuals was 33.7%, significantly correlating with reduced overall quality of life (ß = -4.52; p<0.001). The social quality of life had the highest mean score of 14.24 (±3.45) while the environmental quality of life had the lowest mean score 11.89 (±2.68). Conclusion: Our study reveals a concerning prevalence of PTSD, affecting 1 in 3 individuals, emphasizing the pressing need for comprehensive mental health support within HIV care settings. We observed a significant negative impact of PTSD on overall quality of life, particularly in physical and social aspects. Integrating mental health screening into routine HIV care is crucial, using validated tools like the PSTD Checklist Civilian Version, alongside training for healthcare providers to recognize PTSD symptoms in the context of HIV diagnosis and treatment.

Prevalence and predictors of COVID-19 vaccination hesitancy among healthcare workers in Sub-Saharan Africa: A systematic review and meta-analysis.

BACKGROUND: The COVID-19 vaccination is regarded as an effective intervention for controlling the pandemic. However, COVID-19 vaccine hesitancy is hampering efforts geared towards reducing the burden of the pandemic. Therefore, examining COVID-19 hesitancy and its predictors among healthcare workers is essential to improving COVID-19 uptake. In sub-Saharan Africa, the pooled proportion of COVID-19 vaccine hesitancy is yet to be known. PURPOSE: The present study was to estimate the pooled proportion of COVID-19 vaccine hesitancy and its predictors among healthcare workers in Sub-Saharan Africa. METHODS: A systematic search of articles was conducted in PubMed, Science Direct, African Journal Online, and Google Scholar. Data was extracted with the help of Excel. Data analysis was conducted using STATA 17. Heterogeneity in the studies was assessed using Cochrane Q and 12 tests. A random effects model was used to examine the pooled estimates to determine if heterogeneity was exhibited. RESULTS: A total of 15 studies involving 7498 participants were included in the final analysis. The pooled prevalence of COVID-19 vaccination hesitancy among healthcare workers was 46%, 95% CI (0.38-0.54). The predictors of COVID-19 hesitancy were negative beliefs towards vaccine 14.0% (OR = 1.05, 95% CI: 1.04, 1.06), perceived low risk of COVID-19 infection 24.0% (OR = 1.25, 95% CI: 1.23, 1.28), and vaccine side effects 25.0% (OR = 1.23, 95% CI: 1.21, 1.24). CONCLUSION: The data revealed generally high hesitancy of COVID-19 vaccine among health workers in Sub-Saharan Africa. Future COVID-19 adoption and uptake should be improved by national and individual level efforts. In Sub-Saharan Africa, it is crucial to address the myths and obstacles preventing healthcare professionals from accepting the COVID-19 vaccination as soon as feasible since their willingness to get the vaccine serves as an important example for the broader public.

Uptake and Associated Factors of Male Contraceptive Method Use: A Community-Based Cross-Sectional Study in Northern Uganda.

Background: Uganda has one of the highest fertility rates in Sub-Saharan Africa (SSA). Improving contraceptive uptake in all genders, including males, may be critical to meeting family planning goals in such a setting. Yet, data on male contraception uptake and associated factors in SSA, including Uganda, are limited. We determined the uptake and associated factors of male contraception use in Lira City, Northern Uganda. Methods: We conducted a community-based cross-sectional study from November 12, 2022, to December 12, 2022, among men aged ≥18 years. We used multi-stage sampling to select participants from 12 cells of Lira City divisions of East and West. Data were collected using interviewer-administered structured questionnaires. We defined uptake in males who had used any contraceptive method, including periodic abstinence, withdrawal, condoms, and vasectomy in the previous four weeks. We performed modified Poisson regression to identify associated factors of male contraception uptake. Results: We recruited 401 participants with mean age of 30.4 (±9.3) years. Male contraceptive uptake was 46.4%, 95% CI: 41.5-51.3%. Ever heard about male contraception (adjusted prevalence ratio [aPR] =1.73, 95% CI: 1.172-2.539, p=0.006), willingness to use novel methods (aPR=2.90, 95% CI: 1.337-6.293, p=0.007), both partners being responsible for contraception (aPR: 1.53, 95% CI: 1.113-2.119, p=0.009) were the factors associated with male contraception uptake. Conclusion: We found that nearly half of the men surveyed had used male contraceptive methods in Lira City. Factors associated with the uptake of male contraception included having heard about male contraception, joint couple decision regarding contraception, and the use of novel methods of male contraception. We recommend comprehensive education and awareness campaigns to promote male contraception, with a particular emphasis on encouraging shared decision-making within couples and introducing innovative contraceptive options.

Predictors of Unintended Pregnancy Among Adolescent Girls During the Second Wave of COVID-19 Pandemic in Oyam District in Northern Uganda.

Background: In Uganda, unintended pregnancies are responsible for one in three births with detrimental consequences, a situation that worsened during COVID-19. Thus, the present examined unplanned pregnancy and its associated risks in Oyam district, northern Uganda during the COVID-19 epidemic. Methods and Methods: This study employed a cross-sectional study among adolescent girls aged 15-19 years who had a pregnancy during the second phase of COVID-19 in Oyam district, northern Uganda in November 2022. A consecutive method was employed to recruit the participants attending health facilities. A structured questionnaire was utilized to collect data. For data analysis, both bivariate and multivariable regression methods with adjusted odds ratio and 95% CI were used. A p-value of 0.05 was used to determine the significance level. Results: Of the total respondents, 292 (69.5%) were aged between 18 and 19 years of age, 295 (70.2%) lived in rural areas, and 222 (52.9%) had no formal education. The results also show that 293 (69.8%) of the respondents had unintended pregnancies during COVID-19. The results indicate that participants who lacked knowledge of the ovulation period (AOR: 0.242; 95% CI: 0156-0376; P<0.001), sex education during COVID-19 (AOR: 0.563; 95% CI:: 0.365-0.869; P=0.024) and lacked the freedom to discuss family planning-related issues with family members during COVID-19 (AOR: 0.228; 95% CI: 0.138-0.376; P<0.001) were more likely to have an unintended pregnancy compared to their counterparts. Conclusion: Our study shows that unwanted pregnancies among adolescent girls remain a public health issue in Oyam district with more than two-thirds of adolescents having unwanted pregnancies during the crisis of COVID-19. The major correlates of unwanted pregnancies among adolescent girls during COVID-19 pandemic were inadequate knowledge of the ovulation period, sex education, and lack of freedom to discuss family planning-related issues with family members. There is a need to prioritize interventions, especially in rural settings. Sex education to improve contraceptive use and delay sexual debut. In light of the possibility that social and cultural norms in the Oyam district prohibit parents and children from discussing sexual subjects, it is crucial to promote sexual health education through the mass media, including newspapers, television, radio, and social media.

Factors associated with first antenatal care (ANC) attendance within 12 weeks of pregnancy among women in Lira City, Northern Uganda: a facility-based cross-sectional study.

OBJECTIVE: This study aimed at assessing factors associated with first antenatal care (ANC) attendance within 12 weeks of pregnancy among women in Lira City. DESIGN: A cross-sectional study. SETTINGS: The study was conducted in health facilities offering ANC services in Lira City, Northern Uganda. PARTICIPANTS: The study was among 368 pregnant mothers attending their first ANC in the three selected facilities (Lira Regional Referral Hospital, Ober Health Center IV and Pentecostal Assembly of God Mission Health Center IV) in Lira City. PRIMARY AND SECONDARY OUTCOME MEASURES: Level of first ANC attendance within 12 weeks of pregnancy and associated factors. RESULTS: Early ANC attendance was 36.1%. Women who were: unmarried (adjusted OR (aOR): 0.40, 95% CI: 0.16 to 0.99), took >2 hours to reach a health facility (aOR: 0.21, 95% CI: 0.07 to 0.62), or not visited by village health teams or healthcare workers at home (aOR: 0.33, 95% CI: 0.12 to 0.92) were less likely to attend their first ANC early. On the other hand, women who were: not knowing first that ANC guides parents on infant care (aOR: 2.22, 95% CI: 1.06 to 4.67); pregnant without consent of spouse (aOR: 4.29, 95% CI: 1.75 to 10.55); attending ANC from a private facility (aOR: 2.89, 95% CI: 1.27 to 6.15); and having two to three healthcare workers present at the ANC clinic (aOR: 1.79, 95% CI: 1.03 to 3.13) were more likely to attend ANC early. CONCLUSIONS: Despite the fact that the WHO recommends that all women begin ANC within 12 weeks after conception, Lira City in Northern Uganda had a low overall incidence of timely ANC initiation. Being unmarried, distance to reach a health facility, and being visited by village health teams or healthcare workers at home were all linked to timely ANC commencement. As a result, intervention efforts should concentrate on the highlighted determinants in order to promote ANC initiation in Lira City, Northern Uganda. This can be accomplished by providing information and education to the community on the timing and necessity of ANC in Northern Uganda.

HIV Treatment and Care of Adolescents: Perspectives of Adolescents on Community-Based Models in Northern Uganda.

Background: Differentiated service delivery models for people living with HIV continue to be scaled up to expand access to HIV services and treatment continuity. However, there is a gap in information on adolescents' perspectives on community-based models. We aimed to explore the perspectives of adolescents living with HIV on community-based models in northern Uganda. Materials and Methods: Between February and March 2022, we conducted a descriptive qualitative study at two health centres IV in Northern Uganda. Data was collected using an interview guide. The study had 25 purposively selected adolescents enrolled in community-based models for HIV care and treatment. The interviews were audio-recorded, transcribed verbatim, and translated. We analyzed data using a thematic approach. Results: A total of 25 in-depth interviews with HIV-positive adolescents were conducted. More than half (52.0%) of the participants were females, 84.0% were not married, and 44.0% had no formal education. The mean age of the respondents was 15.6 (±1.9) years. The major themes were: community-based models currently accessed by adolescents, benefits, and challenges of the models. Although there are other community-based models (community pharmacies, home ART deliveries) our exploration only discovered two models used by these adolescents to access care, namely, Community Drug Distribution Point (CDDP) and Community Client-Led ART Delivery Groups (CCLADs). The benefits included reduced transportation costs, convenient service access, ART adherence, peer support, a comfortable environment and less stress. However, our results indicate that these models had some challenges, including lack of confidentiality and privacy, perceived stigma, and a lack of face-to-face interaction. Conclusion: Our findings show that CDDP and CCLADs are the two CBMs used by adolescents in Lira District to access treatment and care. Adolescents benefited from these models through reduced transport costs, the convenience of accessing HIV care and treatment, and social support. The challenges associated with these models are lack of confidentiality and privacy, perceived stigma, and a lack of face-to-face interaction. The Ministry of Health should work with other implementing partners to strengthen the implementation of these models to improve HIV/AIDS service delivery for adolescents.

Factors Influencing the Status of Adherence to Second Clinic Visit Among Clients Newly Diagnosed with HIV in Northern Uganda: A Mixed-Methods Study.

Background: The "test-and-treat" policy may adversely affect adherence to clinic visits of clients newly diagnosed with HIV due to unpreparedness to commence treatment. However, few studies have examined the factors influencing the status of adherence to second clinic visit among clients newly diagnosed with HIV. We examined the factors influencing the status of adherence to second clinic visit among clients newly diagnosed with HIV in Apac District, northern Uganda. Methods: This was a mixed-methods study conducted among 292 systematically sampled clients newly diagnosed with HIV for the survey and 15 purposively sampled clients for the in-depth interview from July to August 2020. Quantitative data were collected using a structured questionnaire, while qualitative data were collected using an interview guide. Quantitative data were analyzed descriptively while qualitative data were analyzed thematically. Results: The mean age of the study participants were 39.5±11 years and their age ranged from 18 to 72 years. Close to three-quarters of study participants adhered to their second clinic visit 74% (214/292). Factors that influenced participants' adherence to the second clinic visit were the adequate HIV pre/post-test counseling positive attitude of clients towards HIV-positive diagnosis, family support, and long waiting time. Conclusion: More than two-thirds of clients newly diagnosed with HIV in Apac District, northern Uganda adhered to their second clinic visit. HIV/AIDS service providers should strengthen HIV pre/post-test counselling, social support systems for persons living with HIV/AIDS, and reduce clients' waiting time to improve adherence to second clinic visit among clients newly diagnosed with HIV.

Chronic stress and coping mechanisms among nurses in Lango sub-region, northern Uganda.

AIM: This study aimed to assess chronic stress and coping mechanisms among nurses in Lango sub-region, northern Uganda, conducted between May and June 2022. DESIGN: Institutional-based cross-sectional design conducted between May and June 2022. METHODS: The study included 498 participants recruited from six health facilities. A 12-Item Short Form Survey tool was used to collect data on chronic stress, while a researcher-developed questionnaire was used to collect data on coping strategies. Descriptive statistics, binary logistic regression and multiple regression were conducted for data analysis. A p-value of 0.05 was considered statistically significant. RESULTS: Out of 498 participants, 153 (30.7%) were aged between 31 and 40 years, 341 (68.5%) were female, 288 (57.8%) were married, and 266 (53.4%) had less than Diploma. Of the 498 participants, 351 (70.5%) experienced chronic stress. The protective factors against chronic stress were being married (AOR: 0.132; 95% CI: 0.043-0.408; p < 0.001), optimizing shift length (AOR: 0.056; 95% CI: 0.027-0.115; p < 0.001), religiosity/Spirituality (AOR: 2.750; 95% CI: 1.376-5.497; p = 0.004), and regular exercise and breaks (AOR: 0.405; 95% CI: 0.223-0.737; p = 0.003).