Understanding the Effect of a Healthcare Provider-Led Family Planning Support Intervention on Contraception use and Pregnancy Desires among Postpartum Women Living with HIV in Southwestern Uganda.

Modern contraceptive prevalence among women living with HIV (WLWH) in Uganda is still low at 45%, and up to a third of women are likely to discontinue the method within the first year of initiation. This increases risks of unplanned pregnancies, perinatal HIV transmission and pregnancy complications. We aim to explore and explain the mechanism of effect of a family planning support intervention investigated in a randomized controlled trial conducted between October 2016 and June 2018 among 320 postpartum WLWH at a referral hospital in Southwestern Uganda that led to improved uptake, decreased contraception discontinuation and lowered pregnancy rates. Thirty WLWH and 10 of their primary sexual partners who participated in this trial were purposively selected and interviewed in the local language; interviews were digitally recorded. Translated transcripts were generated and coded. Coded data were iteratively reviewed and sorted to derive descriptive categories using an inductive content analytic approach. Up to 83% of women wanted to avoid pregnancy within the first year postpartum. Qualitative data showed that contraception uptake and use were influenced by: 1) Participant awareness and understanding of different methods available; 2) Participant perception of offered health services; 3) Healthcare provider (HCP) socio-cultural sensitivity to individual experiences and (mis)conceptions surrounding contraception; 4) Having tactile engagement, follow-up reminders and a reference to prompt action or discussions with partners. Supportive and culturally sensitive HCPs and systems facilitated information sharing leading to increased patient awareness and understanding of the contraceptive methods, and improved health user experience, care engagement, confidence and willingness to take up and continue using modern contraceptive methods.

Patterns and Practices of Self-Medication Among Students Enrolled at Mbarara University of Science and Technology in Uganda.

PURPOSE: Self-medication is drug use without advice from a medical professional. Proper self-medication can reduce health expenses and physician waiting time. However, prescription or over-the-counter drugs are considered unsafe when used irrationally. Presumably, university students can make informed decisions regarding their lives. However, there are limited studies documenting self-medication in Ugandan universities. This study sought to document the prevalence, patterns and factors associated with self-medication among students enrolled at Mbarara University of Science and Technology (MUST). PATIENTS AND METHODS: A descriptive cross-sectional study was done on 385 medical and non-medical students. Data were collected by interviewer-led semi-structured questionnaires and analyzed using the Statistical Package for Social Sciences (SPSS) version 20. The statistical significance was considered as p < 0.05 for both univariate and multivariate analyses. RESULTS: This study showed a 63.5% prevalence of self-medication. Self-medication reasons were classifying illnesses as minor (33%), time-saving (15%), having old prescriptions (11%) and high consultation fees (9%). Not self-medicating reasons included risk of using wrong drugs (19%), insufficient knowledge (17%), fear of side effects (15%), wrong drug use (15%) and misdiagnosis (14%). Respondents accessed drugs from pharmacies (56%), friends/family (17%) or private clinics (15%). Headache relievers, pain relievers and antibiotics were most commonly self-medicated. In adjusted analysis, being female, existing allergies, and being in advanced years of study were associated with increased odds of self-medication. No statistically significant difference existed between medical and non-medical students regarding self-medication. Self-medication likelihood increased with a lack of access to medical services. CONCLUSION: There is a high rate of self-medication amongst female students, those in advanced years of study and those with existing allergies. Medical services access significantly reduced the chances of self-medication. Vital medical services need to be extended to the university students to receive information on medicines, diagnosis, prescription and treatment. More studies should evaluate the impact of a high rate of self-medication among these students.