School of Public Health (Public-Health)
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Browsing School of Public Health (Public-Health) by Subject "Abortion"
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ItemModern contraceptive use among teenage mothers aged 13-19 years in Kamuli District Uganda(Makerere University, 2024) Nshabire, IvanBackground: In Uganda, almost a quarter (24%) of women have given birth by the age of 19, making it the highest teenage pregnancy rate in East Africa. Teenage mothers often face adverse outcomes such as school dropout, social stigmatization, forced marriage, pregnancy complications, and even death. Contraceptive use among teenage mothers is essential to prevent repeat unintended pregnancies for those who are unmarried and to enable appropriate child spacing for those who are married. This study aimed to determine the prevalence and factors associated with modern contraceptive use among teenage mothers in Kamuli district so as to suggest recommendations aimed at preventing teenage pregnancy in the district. Methods: This was a cross-sectional study that utilized quantitative and qualitative data collection techniques. Quantitative data was collected among 286 teenage mothers in three randomly selected sub-counties using a semi-structured questionnaire uploaded to the Kobo Collect. Qualitative data was collected among 20 purposively selected key informants, including community health workers, health facility in charges, local and religious leaders. Quantitative data was cleaned in Microsoft Excel and transferred to STATA version 15 for analysis. Univariate analysis was carried out to describe the data, while the bivariable and multivariable analyses were conducted using modified poison regression. Qualitative data was transcribed verbatim, coded and analysed using manual thematic analysis. Quantitative findings were presented using tables, while qualitative findings were presented using themes and quotes. Results: This study found that out of 286 teenage mothers included in this study, 45% (129/286) were using modern contraceptive. The factors that were associated with modern contraceptive use included: being separated (APR=1.68; 95% CI: 1.22-2.30), being a Muslim (APR= 0.69; 95% CI: 0.48-0.99), finding it difficult to access family planning (APR=0.61; 95% CI: 0.38 0.98), contraceptive services being affordable (APR=1.90; 95% CI: 1.24-2.89), and the culture accepting use of contraceptives (APR=1.83; 95% CI: 1.11-3.01). From the qualitative findings, strategies to scale up modern contraceptive use among teenage mothers included enhancing service accessibility and affordability, community education, improving healthcare worker attitudes, supporting village health teams, and encouraging parental involvement. Conclusion: The prevalence of modern contraceptive use among teenage mothers in Kamuli district was 45%. Factors associated with modern contraceptive use included marital status, religion, accessibility, affordability, and cultural acceptance. To increase contraceptive use, targeted strategies are needed to improve service accessibility and affordability, enhance community education, and foster supportive attitudes among healthcare workers.
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ItemQuality of post abortion care services in Public Health facilities in Kampala – Uganda( 2018-10) Nazziwa, WinfredIntroduction Complications occurring after unsafe abortion contribute to maternal mortality and morbidity in low income countries and are recognized by the international community as an important public health problem. In Uganda, morbidity due to unsafe abortion is still prevalent and is actually higher compared to neighboring countries like Rwanda. Comprehensive and high-quality Post Abortion Care (PAC) services avert repeat unplanned pregnancies and the cycle of repeat abortions; by providing counseling , a broad range of contraceptive services and reproductive health services at the time and location of emergency treatment of abortion complications, and before the patient is discharged from the health facility. Objective: The main objective of the study was to assess the quality of post abortion care services in public health facilities in Kampala. Methods: A facility based, Cross-sectional study design employing quantitative technique for data collection was used. The study used the adopted model of quality of care inspired by the works of Donabedian with three factors: structure, process, and outcome. A total of 280 PAC client exit interviews were conducted, six direct service observations and inventory of the equipment and supplies were utilized to capture the different aspects of quality of care. Results: The age of post-abortion care clients ranged from 15 to 35 years and above with a mean age of 26 years (SD ± 6.39). Using a cut off of 70%, over all, the quality of PAC services was found to be “poor” as only 32.5% of the respondents received “good” quality PAC services. Results revealed post abortion- family planning and linking PAC clients to reproductive health services as some of the procedures largely not done at the health facilities. Conclusion: Greater emphasis should be placed on incorporating post abortion family planning counselling, provision of modern contraceptives and other reproductive health services into this care. Keywords: Quality, Post abortion Care, Abortion, Health facility