Knowledge attitudes and practices towards premarital medical examination among young unmarried people aged 18-49 years in Lyantonde District, Uganda

Abstract

Introduction: Undergoing Premarital Medical Examination (PME) helps couples to ascertain the compatibility of their health status and the likelihood of producing healthy offspring prior to their marriage decisions. This study assessed the Knowledge, Attitudes and Practices (KAP) of young unmarried people towards PME in Lyantonde District.

Methods: A mixed methods study using quantitative and qualitative approaches was carried out among 403 randomly selected young unmarried people aged 18-49 years. Quantitative data was collected using a cross sectional study design. Qualitative data was collected through 8 in-depth interviews and 8 key informant interviews. Thematic analysis was done where atlas-ti version 22 was used to help in the analysis.

Results: Less than a quarter 71/403 (17.6%) of participants had sufficient knowledge about PME. Only 47/403 (11.7%) had a positive attitude while 82/403 (20.3%) had good practices towards PME. Individuals aged 28-32 years (APR= 0.44, 95% CI (0.23-0.85), living 2-3 km from a health facility (APR = 0.13, at 95% CI 0.05-0.32), living more than 4 km away from a health facility (APR = 1.55, at 95% CI 1.04 - 2.33) were significantly associated with good practices. Females (APR=1.9, 95% CI (1.01 - 3.60)), individuals aged 33-37 years (APR = 5.1 at 95% CI 1.96 - 13.4), a monthly income of 60,000-199,999 Ugx (APR =0.53, 95% CI 0.32 - 0.91), living 2 to 3 km away from a health facility APR = 0.43 at 95% CI 0.21 - 0.85) were significantly associated with positive attitude. Individuals aged 23-27 years (APR=0.49, 95% CI (0.25 - 0.94), 28-32 years APR= 0.41, 95% CI (0.19 - 0.86) and living more than 4 km away from a health facility APR = 1.92, at 95% CI (1.12 - 3.29) were significantly associated with good knowledge. Qualitative results indicate participants were aware of PME to know each other's health status before marriage. Most information came from health workers and radio programs. Many were unfamiliar with diseases tested beyond HIV. Most prioritized HIV testing and had limited knowledge of other diseases.

Conclusion: There is poor knowledge, attitude and practice towards comprehensive PME beyond HIV testing. Poor knowledge of genetic and sexually transmitted diseases other than HIV indicates a need for health education on the importance of testing for these. Improvements can come through increased healthcare access, health education, sensitization, and premarital counseling.