Kabale School of Medicine (KABSOM)

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  • ItemOpen Access
    Factors Influencing the Uptake of Adolescents’ Sexual and Reproductive Health Services in Rubanda District, South Western Uganda.
    (Kabale University, 2023) Tayebwa, Amon
    Introduction: Globally, adolescents face a remarkable challenge of insufficient access to sexual and reproductive health (SRH) education and services. However, even where such services exist, often their uptake by the adolescents tends to be low as a result of a number of factors. The main aim for this study, therefore, was to assess the factors influencing the uptake of adolescents’ sexual and reproductive health services in Rubanda District. Methodology: The study adopted descriptive cross-sectional design with qualitative and quantitative approach. A total of 387 adolescent respondents drawn from target population of 21273 were involved in the study that used a self-administered questionnaire and focus group discussions. Key informant interviews were also carried out at selected health facilities. Quantitative data was analysed using Statistical Package for Social Sciences (SPSS) version 24. Results: Of the 387 study participants, 136(35.1%) accessed ASRH services in Rubanda district. The most commonly offered ASRH was HIV testing and counselling, 66(17.1%), while most ASRH services were offered at Hamurwa HC IV, 93(24.0%) and Muko HCIV 45(22.4%). The results also revealed that older age (18-19 years; AOR= 2.1; 95%CI: 1.2-3.5, p <0.001) and residence in other town council than Bubaare (Hamurwa; AOR = 2.1, 95%CI: 0.8-5.8, p = 0.134; Rubanda; AOR = 3.6; 95%CI: 1.9-6.7, p <0.001; Ikumba; AOR = 3.6; 95%CI: 1.9-6.9, p <0.001) were associated with higher access to ASRH services, while females were less likely to utilize ASRH (AOR= 0.5, 95%CI: 0.3-0.9, p = 0.020). Conclusions and recommendations: The uptake of SRHS in the study was low and was attributed to age, sex, and residence; and there were suggestions that it could be improved by making the health facilities comfortable for adolescents, particularly by providing separate units and time for the consultations. The study recommends strengthening access to youth-friendly reproductive health services by according the adolescents the privacy they need.
  • ItemOpen Access
    Factors Associated with Male Partner Support During Pregnancy and Child Birth in Kabale District.
    (Kabale University, 2023) Niwarinda, Denesi
    Background: Pregnancy and child births are natural processes but by no means risk-free. Efforts to improve maternal and child’s health services have been made, but poor outcomes of pregnancy and child’s birth remain high in Sub Saharan Africa. The study sought to assess factors associated with male partner support during pregnancy and child birth in selected public and faith-based health facilities in Kabale district in Uganda. Methods: The study employed a descriptive cross-sectional design using quantitative approach to assess 318 mothers using convenience sampling method. Both predictor variables that included health facility service factors, social –cultural factors and demographics as well as support as an outcome were assessed using a semi-structured questionnaire. Quantitative data generated from the field was analyzed using descriptive and inferential statistics and presented in frequencies and percentages, and logistics regression was used to trace the associations between study variables and male partner support during pregnancy and child birth at 0.05 level of significance. Results: The main findings of the study indicate that 216/318 (68%) had low male partner support during pregnancy and child birth and only 102(32%) had high male partner support during pregnancy and child birth. The study found a significant association between health related factors and support women receive from their male partners (OR=1.16, 95%CI: 1.08 to 1.25, p<0.001). Additionally, contextual / social cultural-related factors were also significantly associated with support women received from their male partners during pregnancy and childbirth (OR=1.19 95%CI: 1.03c to 1.38, p=0.017). Conclusion: The study recommends building capacity of health workers on male support, priotizing the adoption of resource package for engaging men in pregnancy and childbirth and its implementation, awareness through outreaches and media, incentives at each facility for male partners support and community engagement on male support in pregnancy and child birth.
  • ItemOpen Access
    Factors Associated with Male Partner Support During Pregnancy and Child Birth in Kabale District.
    (Kabale University, 2023) Niwarinda, Denesi
    Background: Pregnancy and child births are natural processes but by no means risk-free. Efforts to improve maternal and child’s health services have been made, but poor outcomes of pregnancy and child’s birth remain high in Sub Saharan Africa. The study sought to assess factors associated with male partner support during pregnancy and child birth in selected public and faith-based health facilities in Kabale district in Uganda. Methods: The study employed a descriptive cross-sectional design using quantitative approach to assess 318 mothers using convenience sampling method. Both predictor variables that included health facility service factors, social –cultural factors and demographics as well as support as an outcome were assessed using a semi-structured questionnaire. Quantitative data generated from the field was analyzed using descriptive and inferential statistics and presented in frequencies and percentages, and logistics regression was used to trace the associations between study variables and male partner support during pregnancy and child birth at 0.05 level of significance. Results: The main findings of the study indicate that 216/318 (68%) had low male partner support during pregnancy and child birth and only 102(32%) had high male partner support during pregnancy and child birth. The study found a significant association between health related factors and support women receive from their male partners (OR=1.16, 95%CI: 1.08 to 1.25, p<0.001). Additionally, contextual / social cultural-related factors were also significantly associated with support women received from their male partners during pregnancy and childbirth (OR=1.19 95%CI: 1.03c to 1.38, p=0.017). Conclusion: The study recommends building capacity of health workers on male support, priotizing the adoption of resource package for engaging men in pregnancy and childbirth and its implementation, awareness through outreaches and media, incentives at each facility for male partners support and community engagement on male support in pregnancy and child birth.
  • ItemOpen Access
    Assessing the Factors Influencing Attrition of Health Workers in Government Health Units in Lyantonde District, Uganda.
    (Kabale University, 2023) Kansiime, Benon
    Introduction The shortage of health workers remains a critical public health issue globally despite of national strategic plans enacted in 2014 by world leaders which aimed at handling the shortage of health workforce. This study assessed the factors influencing attrition of health workers in government health units in Lyantonde district, Uganda. This was guided by three specific objectives of the study which were to: find out the drivers of attrition of health workers in Lyantonde district; determine the effects of attrition of health workers in Lyantonde district; and establish retention measures of health workers in Lyantonde district. Methodology Across sectional study of collecting qualitative and quantitative data was conducted on 171 study participants including health workers, Chief Administrative Officer, the District Health Officer, the District Principal Human Resource Officer, Secretary District Service Commission, the Chairperson District Service Commission, the District Principal Internal Auditor, and Secretary for Health, Medical superintendent Lyantonde Hospital, District Planner and the Chief Finance Officer. Frequencies, percentages, means, standard deviations and correlations were used to achieve the objectives. Thematic analysis was used to analyse the qualitative data. Results 171 respondents participated in the study making a response rate of 95%, 34.5% were males, and 65.5% were females. The cadre distribution of the participants was as follows: Medical Officers 5 (2.9%), clinical officers 14 (8.2%), Nursing 82 (48.0%), Health Assistant 11(6.4%), Health inspector 4 (2.3), Radiographers 2 (1.2), Laboratory Assistants 9 (5.3%), Laboratory technicians 3(1.8%), Dispensers 2 (1.2%), Orthopaedic officer 1 (0 .6%), and Midwives 38 (22.2%). The drivers of attrition included: low pay/salary/allowances 49.7%, limited opportunities for promotion 51.5%, poor/lack of utilities 62.6%, lack of housing facilities 75.4%, and poor education facilities for health workers 48.5%. the effect of attrition of health workers included; shortage of health workers 85.5%, lack of access to all health services in the facilities 73.1%, and poor service delivery 43.3%. Moreover, on measures to mitigate the attrition of health workers, the following were found to be most important: provision of accommodation to the health workers (Mean=4.02), the government should provide training and promotion outlets (Mean=4.08), provision of incentives (Mean=4.31), provision of retention allowances (Mean=4.16). However, respondents were not sure if good relationship between the community and the health workers can lead to retention (Mean=3.0), and Availability of infrastructure and quality services (Mean=3.82). Discussion: The majority of the health workers have enough experience by they still face challenges of: inadequate pay, lack of equipment, health units accessibility, and availability of housing and social amenities which may contribute to their attrition. The effects of attrition of health workers cited in the study were: shortage of health workers, inadequate service provision, and patients did not access all services. Measures to mitigate the attrition of health workers cited in the study were provision of accommodation to health workers, training and promotion outlets for health workers with additional qualifications, provision of retention allowances especially to those working in the hard to reach areas.
  • ItemOpen Access
    Factors Associated with Hand Washing Practices Among Secondary School Students in Ndorwa East Constituency in Kabale District.
    (Kabale University, 2021) Twinomuhwezi, Benja
    Despite the world-wide Global Hand Washing Day campaign which targets school children as the most effective agents for behaviour change, there is limited documentation in various school settings. This study examined the factors associated with hand washing practices among secondary school students in Ndorwa east constituency. It was guided by two objectives; (i) to assess hand washing practices among secondary schools in Ndorwa East Constituency in Kabale district; (ii) to assess the factors associated with hand washing practices among the secondary school students in Ndorwa East Constituency. A cross-sectional study using quantitative method was conducted among 291 students from five schools. For qualitative data, the researcher used purposive sampling to identify 11 key informants (head teachers and teachers in charge of health and sanitation) and 48 participants in FGDs from the five schools. Systematic sampling was used to select students to participate in the study while simple random sampling was used to identify schools to participate in the study. Of the 291 respondents enrolled, 219(77%) washed their hands after the rest room. Factors associated with a higher likelihood of hand washing practice among secondary school students in Ndorwa East Constituency–Kabale District were being aged <18 years (aOR =8.1, 95%CI: 2.65-21.61, p<0.001), presence of water for hand washing(aOR =50.7,95%CI:11.50-309.38,p<0.001), presence of hand washing stations (aOR=7.3,95%CI:2.72-30.37, p<0.001), and cleanliness of hand washing stations (aOR=70.0,95%CI:10.44-605.6, p<0.001). The factors associated with hand washing practices were presence of water for hand washing, presence of hand washing stations in schools, cleanliness of hand washing stations. The study suggests that the school administrators should sensitize all students to continue practicing washing hands. This would help in preventing students from diseases associated with poor hand hygiene practices. Keywords: Factors, Hand Washing Practices, Secondary School Students, Ndorwa East Constituency, Kabale District.
  • ItemOpen Access
    Factors Associated with Stunting in Children Under Five Years of Age: A Case of Buhara Sub County, Kabale District.
    (Kabale University, 2022) Namanya, Oliver
    Under nutrition, especially stunting has continued to be a health burden among children of less than five years of age living in low- and middle-income countries. Kigezi sub region, Kabale District is faced with the problem of child stunting with 30 percent of the under-five years stunted. The study assessed factors associated with stunting among children less than five years of age in Buhara Sub County Kabale District. The study employed a cross-sectional descriptive design with qualitative and quantitative strategies in data collection from 380 participants drawn from a population of 5728 households. Data were collected using validated questionnaires and interviews over a period of one month with the help of trained research assistants. Generated data were exported to Statistical Package for Social Sciences (SPSS) version 21 and analysed in frequencies, percentages, confidence intervals, chi-square test and multinomial regression and presented in tables and charts. The study made the following findings in line with the objectives: low household income, child illness in the last few weeks incomplete child vaccination (p- Value = 0.005 < 0.05 and p- value = 0.001 < 0.05), the child’s guardian ethnicity with (p- value = 0.013 < 0.05 and 0.000), open defecation, indiscriminate waste disposal, 18(4.7%) 95 CI= 028311725 - .073831273) and use of unprotected water sources, were the major factors associated with stunting. The child gender, child’s care taker and child’s birth order were equally linked with stunting with (p- Value = 0.023 < 0.05, p- value = 0.003 < 0.05 and, p- value = 0.002 < 0.05) respectively. The MUAC of children in the study with yellow result was 2.6% (.012690006 - .047862066), standard deviation of height 11.3cm and weight 2.7kg. The household financial security was seen to have influenced household food security, diversification, and supplementation. About 82(21.6%, CI; 175466713 - .260603736 eat supplements once a months, while 187(49.2%, CI; (.440755412 - .543579017 do not eat any food supplements at all. The child’s household source of drinking water was significant to nutritional status of children under 5 years especially with regards to drinking water from unprotected source which is the predisposing factor to gastrointestinal infection that is among the risk factor for stunting. The study recommended that, Kabale District local government in conjunction with Buhara Sub County leadership should come up with ordinances and byelaws on how to improve community sanitation and hygiene practices especially improving toilet coverage, hand washing and proper disposal of the wastes to avoid stunting as they pose great risk to diarrheal diseases leading to mal-absorption food. Keywords Stunting Children, Under Five Years, Age, Buhara Sub-County, Kabale District.
  • ItemOpen Access
    Magnitude and Factors Associated With Risky Sexual Behaviours among Undergraduate Students in Selected Universities in Kigezi Sub Region
    (Kabale University, 2022) Amon, Bahati
    Although the Uganda government policy has tried to put in place measures that would minimise to promote sexual and reproductive health, there have been reports of rampant risky sexual behaviour especially among the youths most especially among university students. However, prior to the current study, the problem had not been explored with regard to the universities in the Kigezi sub-region, all of which are new. The current study assessed the prevalence andfactors associated with risky sexual behaviors among undergraduate students in selected universities in Kigezi sub-region as well the unmet needs with regard to sexual health services An institution based cross sectional study was conducted among 1056 study participants from target population of 5303 using a self-administered pre-tested questionnaire, key informant interview and direct observations using a pre-deigned checklist, to collect the data. The results showed the prevalence of sexual behaviour were as follows: Having multiple partners 494 (47%), being unfaithful to their sexual partners 348(33%) and inconsistence condom use 214(20%) It was also revealed that the factors that influenced the students to be involved in risky sexual behaviour included cold climate reported by 806 (76.3%) of respondents; limited condom provision and irregular replacement pattern in the Universities by 671 (63.5%, 605567936 - .664508207); and limited family planning programs and activities in the Universities with about 673 (63.7%, CI:0.61 - 0.67) of respondents. From the multinomial regression analysis, the study revealed the following variables to be statistically significant in relation to the prevalence of risk sexual behaviour: the individual or personal linked risky behaviors (p- value = 0.000 < 0.05); the contextual and environment related risk factors (p- value = 0.03 < 0.05). The unmet need was mainly in terms of sexual reproductive health services (p- value = 0.000 < 0.05 and p- value = 0.000 < 0.05).In conclusion, the study revealed that there is high prevalence of risky sexual behaviour in the study population which is influenced by cold climate, limited condom provision and irregular replacement pattern and limited family planning programs in the Universities with a significant unmet need for sexual health services in form of family planning services, sexual health activities sexual health counseling. The study therefore, recommends designing and implementing sexual risk reduction programs in university-based health care services in Uganda.
  • ItemOpen Access
    Factors Associated with Hand Washing Practices among Secondary School Students in Ndorwa East Constituency in Kabale District
    (Kabale University, 2021) Benja, Twinomuhwezi
    Despite the world-wide Global Hand Washing Day campaign which targets school children as the most effective agents for behaviour change, there is limited documentation in various school settings. This study examined the factors associated with hand washing practices among secondary school students in Ndorwa East Constituency. It was guided by two objectives: (i) to assess hand washing practices among secondary schools in Ndorwa East Constituency in Kabale district; (ii) to assess the factors associated with hand washing practices among secondary school students in Ndorwa East Constituency. A cross-sectional study using quantitative method was conducted among 291 students from five schools. For qualitative data, the researcher used purposive sampling to identify 11 key informants (head teachers and teachers in charge of health and sanitation) and 48 participants in FGDs from the five schools. Systematic sampling was used to select students to participate in the study, while simple random sampling was used to identify schools to participate. Of the 291 respondents enrolled, 219(77%) washed their hands after the rest room. Factors associated with a higher likelihood of hand washing practice among secondary school students in Ndorwa East Constituency–Kabale District were being aged <18 years (aOR =8.1, 95%CI: 2.65-21.61, p<0.001); presence of water for hand washing (aOR =50.7,95%CI:11.50-309.38,p<0.001); presence of hand washing stations (aOR=7.3,95%CI:2.72-30.37, p<0.001); and cleanliness of hand washing stations(aOR=70.0,95%CI:10.44-605.6, p<0.001). The factors associated with hand washing practices were presence of water for hand washing; presence of hand washing stations in schools; cleanliness of hand washing stations. The study suggests that the school administrators should sensitize all students to continue practicing washing hands. This would help in preventing students from diseases associated with poor hand hygiene practices.
  • ItemOpen Access
    Complementary feeding practices and Associated Factors in Children below the Age of 24 Months in Kitumba Sub County-Kabale District
    (Kabale University, 2021) Valentine, B.K. Birungi
    The UDHS 2016 portrayed Kigezi sub region with nine per cent of children suffering malnutrition and stunting. This was attributed to poor nutritional practices among other factors. A few studies have been done in the region to assess the factors which influence complementary feeding practices among the children below the age of 24 months. This study was to determine the prevalence of complementary feeding practices; describe indicators of complementary feeding and identify the socio-demographic factors associated with children feeding in Kitumba Sub county, Kabale district. The study was a descriptive cross-sectional survey which used qualitative and quantitative methods of data collection. The study found out that the prevalence of complementary feeding was generally low (58%). Both parents were involved in child feeding even though it was perceived that child feeding was the mother’s responsibility. Mothers made the decisions on when to introduce complementary feeding and had the responsibility to introduce complementary feeding. Maize porridge and sorghum was provided to the children alongside paste and vegetables. Children were encouraged to eat by giving them attention. If a child kept crying after breastfeeding, it was perceived that he/she did not get satisfied and this was a justification for early initiation of complementary food. Sickness and death of a breastfeeding mother also influenced early initiation of food. Age and education of caretakers significantly influenced complementary feeding practices of children. It is imperative that programmes focused on increasing complementary feeding practices should be conducted such as comprehensive nutrition education by health workers, making home visits, and reinforcement of IYCF through local leaders following the WHO guideline.
  • ItemOpen Access
    Exploring the Integration of Nutrition Care Services into Health Care System in Ntungamo District.
    (Kabale University, 2018) Hope, Katusiime
    This study explored the integration of nutrition care services into the Health Care system in Ntungamo District. The general objective of this study was to explore the factors influencing progress in integration of nutrition care services into the Health Care system in Public Health facilities in Ntungamo District; as a means of increasing access to and utilization of nutrition services. The study also described the knowledge and attitude of staff on integration of Nutrition care services in Public Health facilities, to identify the systems and structures in place for promoting integration of nutrition care services into Health Care system in Public Health Facilities and to examine the available policies and guidelines on integration of Nutrition care services in Public Health facilities in Uganda, and their utilization in Ntungamo District. It was a cross sectional descriptive study involving 196 respondents and carried out in one hospital and three HCIVs. Quantitative data was collected by using open ended questions and qualitative data was obtained through Focus Group Discussions, and Key Informant Interviews. Quantitative data was analyzed using SPSS version 16.0 while qualitative data was analyzed using thematic and content analysis.There was minimal integration of Nutrition care services in Public Health facilities in Ntungamo District. The factors significantly influencing the level of integration were, Cadre of staff, nutrition trainings received, holding regular meetings, and usage of the national nutrition care policy and guidelines. The policies and guidelines on integration of Nutrition care services in Public Health facilities in Ntungamo District were less regularly implemented although they were available in most health facilities. In regard to examining the association between the policies and guidelines to integration of nutrition care services, it was evident that integration of nutrition care services differed by cadre of staff, attendance nutrition trainings, conducting meetings at the facilities and usage of the national nutrition care policy and guidelines. From the findings, it is recommend that health facilities hold regular (at least quarterly) meetings to review nutrition indicators as one of the policy structures and this should be done by in charges of health facilities. In order to improve the integration and performance of integrated services, it was recommended that the district: Increases funding to nutrition activities in district budget and work plan, Conducts trainings to improve on capacity building of all health workers including Doctors and clinical officers and enhances usage/utilization of nutrition care policies be emphasized by Ministry of Health across the country.