Mukono, Uganda

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Mbonye A.K.,Ministry of Health | Asimwe J.B.,Uganda Christian University
International Journal of Adolescent Medicine and Health | Year: 2010

Uganda has high maternal mortality ratio of 435/100,000 live births. In order to address this, Uganda has developed a strategy and has prioritized skilled attendance at delivery as a key intervention. Methods: A survey covering 54 districts and 553 health facilities was conducted to determine availability and access to essential maternity care and health system factors related to maternal health. The survey specifically assessed availability of emergency obstetric care (EmOC) signal functions, the state of health infrastructure and availability of basic drugs and supplies. Results: A total of 194,029 deliveries were recorded in the year preceding the survey. Majority, 117,761 (60.7%) occurred in hospitals, while 76,268 (39.3%) occurred in health centers. The following factors were associated with increased deliveries at health facilities; running water, (RR 1.5, P < .001); electricity, (RR 1.4, P < .001) and accommodation for staff, (RR 1.2, P < .002). Health units providing basic EmOC had the highest chances of attracting women to deliver there, (RR 4.0, P < .001) as well as those providing comprehensive EmOC, (RR 3.1, P < .001). Furthermore, the majority of health facilities expected to offer basic EmOC, 349 (97.2%) were not offering the service. This is the likely explanation for the high health facility-based maternal ratio of 671/100,000 live births in Uganda. Conclusions: Improving availability and quality of care especially EmOC; and ensuring that health units have electricity, running water and accommodation for staff could increase skilled attendance at delivery and help achieve the Millennium Development Goals (MDG) target on maternal health in Uganda.


Leerlooijer J.N.,Wageningen University | Kok G.,Maastricht University | Weyusya J.,African Rural Development Initiatives | Bos A.E.R.,Open University | And 4 more authors.
Health Education Research | Year: 2014

Out-of-wedlock pregnancy among adolescents in sub-Saharan Africa is a major concern, because of its association with health, social, psychological, economic and demographic factors. This article describes the development of the Teenage Mothers Project, a community-based intervention to improve psychological and social well-being of unmarried teenage mothers in rural Uganda. We used Intervention Mapping (IM) for systematically developing a theory and evidence-based comprehensive health promotion programme. A planning group consisting of community leaders, teenage mothers, staff of a community-based organization and a health promotion professional was involved in the six steps of IM: needs assessment, programme objectives, methods and applications, intervention design, planning for adoption and implementation and planning for evaluation. The programme includes five intervention components: community awareness raising, teenage mother support groups, formal education and income generation, counselling, and advocacy. The intervention components are based on a variety of theoretical methods, including entertainment education, persuasive communication, mobilization of social networks and social action. In conclusion, IM facilitated the planning group to structure the iterative, bottom-up, participatory design of the project in a real-life setting and to use evidence and theory. The article provides suggestions for the planning of support interventions for unmarried teenage mothers. © 2014 The Author.


Kiondo P.,Makerere University | Wamuyu-Maina G.,Makerere University | Bimenya G.S.,Makerere University | Tumwesigye N.M.,Makerere University | And 2 more authors.
Tropical Medicine and International Health | Year: 2012

Objective Pre-eclampsia contributes significantly to maternal, foetal and neonatal morbidity and mortality. The risk factors for pre-eclampsia have not been well documented in Uganda. In this paper, we describe the risk factors for pre-eclampsia in women attending antenatal clinics at Mulago Hospital, Kampala. Methods This casecontrol study was conducted from 1st May 2008 to 1st May 2009. 207 women with pre-eclampsia were the cases, and 352 women with normal pregnancy were the controls. The women were 15-39years old, and their gestational ages were 20weeks or more. They were interviewed about their socio-demographic characteristics, past medical history and, their past and present obstetric performances. Results The risk factors were low plasma vitamin C (OR 3.19, 95% CI: 1.54-6.61), low education level (OR 1.67, 95% CI: 1.12-2.48), chronic hypertension (OR 2.29, 95% CI 1.12-4.66), family history of hypertension (OR 2.25, 95% CI: 1.53-3.31) and primiparity (OR 2.76, 95% CI: 1.84-4.15) and para≥5 (3.71, 95% CI:1.84-7.45). Conclusion The risk factors identified are similar to what has been found elsewhere. Health workers need to identify women at risk of pre-eclampsia and manage them appropriately so as to prevent the maternal and neonatal morbidity and mortality associated with this condition. © 2011 Blackwell Publishing Ltd.


Kiondo P.,Makerere University | Wamuyu-Maina G.,Makerere University | Wandabwa J.,Walter Sisulu University | Bimenya G.S.,Makerere University | And 2 more authors.
BMC Pregnancy and Childbirth | Year: 2014

Background: Oxidative stress plays a role in the pathogenesis of pre-eclampsia. Supplementing women with antioxidants during pregnancy may reduce oxidative stress and thereby prevent or delay the onset pre-eclampsia. The objective of this study was to evaluate the effect of supplementing vitamin C in pregnancy on the incidence of pre-eclampsia, at Mulago hospital, Kampala, Uganda.Methods: This was a (parallel, balanced randomization, 1:1) placebo randomized controlled trial conducted at Mulago hospital, Department of Obstetrics and Gynecology. Participants included in this study were pregnant women aged 15-42 years, who lived 15 km or less from the hospital with gestational ages between 12-22 weeks. The women were randomized to take 1000mg of vitamin C (as ascorbic acid) or a placebo daily until they delivered. The primary outcome was pre-eclamsia. Secondary outcomes were: severe pre-eclampsia, gestational hypertension, preterm delivery, low birth weight and still birth delivery. Participants were 932 pregnant women randomized into one of the two treatment arms in a ratio of 1:1. The participants, the care providers and those assessing the outcomes were blinded to the study allocation.Results: Of the 932 women recruited; 466 were randomized to the vitamin and 466 to the placebo group. Recruitment of participants was from November 2011 to June 2012 and follow up was up to January 2013. Outcome data was available 415 women in the vitamin group and 418 women in the placebo group.There were no differences in vitamin and placebo groups in the incidence of pre-eclampsia (3.1% versus 4.1%; RR 0.77; 95% CI: 0.37-1.56), severe pre-eclampsia (1.2% versus 1.0%; RR 1.25; 95% CI: 0.34-4.65), gestational hypertension(7.7% versus 11.5%; RR 0.67; 95% CI: 0.43-1.03), preterm delivery (11.3% versus 12.2%; RR 0.92; 95% CI: 0.63-1.34), low birth weight (11.1% versus 10.3%; RR 1.07; 95% CI: 0.72-1.59) and still birth sssdelivery (4.6% versus 4.5%; RR 1.01; 95% CI: 0.54-1.87).Conclusions: Supplementation with vitamin C did not reduce the incidence of pre-eclampsia nor did it reduce the adverse maternal or neonatal outcomes. We do not recommend the use of vitamin C in pregnancy to prevent pre-eclampsia.Trial registration: This study was registered at the Pan African Clinical Trial Registry, PACTR201210000418271 on 25th October 2012. © 2014 Kiondo et al.; licensee BioMed Central Ltd.


Kiondo P.,Makerere University | Kiondo P.,Walter Sisulu University | Kiondo P.,Uganda Christian University
The Pan African medical journal | Year: 2014

INTRODUCTION: Pre-eclampsia, which is more prevalent in resource-limited settings, contributes significantly to maternal, fetal and neonatal morbidity and mortality. However, the factors associated with these adverse outcomes are poorly understood in low resource settings. In this paper we examine the risk factors for adverse neonatal outcomes among women with pre-eclampsia at Mulago Hospital in Kampala, Uganda.METHODS: Pre-eclampsia, which is more prevalent in resource-limited settings, contributes significantly to maternal, fetal and neonatal morbidity and mortality. However, the factors associated with these adverse outcomes are poorly understood in low resource settings. In this paper we examine the risk factors for adverse neonatal outcomes among women with pre-eclampsia at Mulago Hospital in Kampala, Uganda.RESULTS: Predictors of adverse neonatal outcomes were: preterm delivery (OR 5.97, 95% CI: 2.97-12.7) and severe pre-eclampsia (OR 5.17, 95% CI: 2.36-11.3).CONCLUSION: Predictors of adverse neonatal outcomes among women with pre-eclampsia were preterm delivery and severe pre-eclampsia. Health workers need to identify women at risk, offer them counseling and, refer them if necessary to a hospital where they can be managed successfully. This may in turn reduce the neonatal morbidity and mortality associated with pre-eclampsia.


Wesonga R.,Makerere University | Nabugoomu F.,Uganda Christian University | Jehopio P.,Makerere University
Journal of Air Transport Management | Year: 2012

The study analyses ground delays and air holding at Entebbe International Airport over five years. Daily probabilities for aircraft departure and arrival delays at are generated for each. The mean probabilities of delay for ground delays and air holding at 50% delay threshold levels are 0.94 and 0.82 that fall to 0.49 and 0.36 when 60% delay threshold levels are used. Simulations are performance for delay threshold levels to monitor for the trends of the daily probabilities for the study period. The general conclusion is that a parameter-based framework is best suited to determine the probability of aircraft delay at an airport. © 2012 Elsevier Ltd.


Namirembe S.,International Center for Research in Agroforestry | Leimona B.,International Center for Research in Agroforestry | Van Noordwijk M.,International Center for Research in Agroforestry | Bernard F.,International Center for Research in Agroforestry | Bacwayo K.E.,Uganda Christian University
Current Opinion in Environmental Sustainability | Year: 2014

Multiple paradigms have emerged within the broad payments for ecosystem services (ES) domain for internalizing externalities of local land-use change decisions. These range from reward of ready-made ES delivery (commoditised) to reward of processes of ES generation (co-investment). Evidence from tree-based projects in Africa suggests that currently, only carbon sequestration and emission reduction are 'commoditised', however in an artificial way where payments are not matched to ES delivery, but adjusted or supplemented with co-benefits. Co-investment in stewardship alongside rights is more widespread and versatile for a variety of ES. Efficiency concerns of co-investment schemes can be addressed when commoditised ES or profitable enterprises with positive ES externalities evolve from these. © 2013 The Authors.


Katusiimeh M.W.,Uganda Christian University | Katusiimeh M.W.,Wageningen University | Mol A.P.J.,Wageningen University | Burger K.,Wageningen University
Habitat International | Year: 2012

This paper compares the operations and discusses the effectiveness of public and private sector provision of solid waste collection in Kampala, Uganda. Household data suggest that the private sector is more effective than the public sector. Private sector companies provide services like container provision and providing timely and fixed collection time tables. Contrary to popular perception, fees charged by private companies are moderate. Public sector clients are charged fees even when the service is supposed to be free. Clients of private sector providers are more satisfied than those of public sector providers. It is however, revealed that while public sector serve mainly the low incomes, the private sector serves mainly the rich. In spite of these notable differences, clients of both public and private sector perceive the problem of solid waste management (SWM) in Kampala to be very serious. The effectiveness of public and private sector operations in solid waste collection in Kampala is hampered by corruption and lack of transparency. Given the situation of open competition for clients involving both public and private sector in Kampala, it is possible the public sector can operate effectively if they start commercial services officially like their private sector counterparts. This calls for a formal public-private partnership where the public and private sector can work together with the public sector dominating poor and marginalized areas while the private sector concentrates on rich neighborhoods. © 2011 Elsevier Ltd.


Katusiimeh M.W.,Uganda Christian University | Burger K.,Wageningen University | Mol A.P.,Wageningen University
Habitat International | Year: 2013

We analyze how the informal collectors and the formal sector co-exist in solid waste collection in Kampala. We rely on household surveys and a small survey among the informal collectors in Kampala. Findings suggest that informal collectors play a substantial role in the first stage e collecting solid waste from the households, notably from poorer segments of the population. This is not the 'dualist' aspect of poor earnings but actually made possible by them escaping control on where to deposit the waste. Employing a simple technology, and bringing the waste no farther than the nearest unofficial 'collection point', they provide services at low cost to the households, but much less so to the community (environmentally of little use). If public provisions can be made for the second stage in waste collection, this may trigger even more supply of small-scale collecting services, a combination that may prove cost effective. © 2012 Elsevier Ltd.


Kyakulumbye S.,Uganda Christian University | Katono I.W.,Uganda Christian University
Proceedings of the International Conference on e-Learning, ICEL | Year: 2013

The study investigates how ICT integration in the primary school curriculum is managed in Uganda. School management practices were conceptualized as planning, organization and coordination. The dependent variable is ICT integration. The study is a cross sectional survey using mainly quantitative data. The population comprised teachers and school head teachers in Mukono District in Uganda. Data was collected using self administered questionnaires using a likert scale. The response rate of 94.2% was sufficient to rely on the results of this study. Data was analyzed using descriptive statistical analysis, correlation analysis (Pearson Product Moment Correlation Coefficient) and multiple regression analysis to establish the causal influence of management practices on ICT integration. The major finding of this study was that planning, coordination and organization significantly impacts ICT integration. A multiple regression analysis revealed that all the management practices had a casual effect on ICT integration. Recommendations are made that the state should formulate and implement policies to schools to regulate ICT implementation and prescribe strategies to influence teachers' attitude to ICT integration, and offer support to school management to enhance their management practices in order to manage the ICT integration process into the curriculum. In addition, based on the research, we propose that more software and hardware should be made available to schools. Further research may measure the management styles and change management strategies that may be adopted in order to successfully integrate ICT into the primary school curriculum. Such a study may be triangulated with the qualitative views from the respondents.

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