BackgroundHumanitarian crises and migration make girls and women more vulnerable to poor sexual and reproductive health (SRH) outcomes. Nevertheless, there is still a dearth of information on SRH outcomes and access to SRH services among refugee girls and young women in Africa. We conducted a mixed-methods study to assess SRH experiences, knowledge and access to services of refugee girls in the Nakivale settlement, Uganda.MethodsA cross-sectional survey among 260 adolescent girls 13–19 years old was conducted between March and May 2018. Concurrently, in-depth interviews were conducted among a subset of 28 adolescents. For both methods, information was collected regarding SRH knowledge, experiences and access to services and commodities. The questionnaire was entered directly on the tablets using the Magpi® app. Descriptive statistical analysis and multinomial logistic regression were performed. Qualitative data was transcribed and analysed using thematic content analysis.ResultsA total of 260 participants were interviewed, with a median age of 15.9 years. The majority of girls were born in DR Congo and Burundi. Of the 93% of girls who had experienced menstruation, 43% had ever missed school due to menstruation. Regarding SRH knowledge, a total of 11.7% were not aware of how HIV is prevented, 15.7% did not know any STI and 13.8% were not familiar with any method to prevent pregnancy. A total of 30 girls from 260 were sexually active, of which 11 had experienced forced sexual intercourse. The latter occurred during conflict, in transit or within the camp. A total of 27 of 260 participants had undergone female genital mutilation (FGM). The most preferred sources for SRH information was parents or guardians, although participants expressed that they were afraid or shy to discuss other sexuality topics apart from menstruation with parents. A total of 30% of the female adolescents had ever visited a SRH service centre, mostly to test for HIV and to seek medical aid for menstrual problems.ConclusionsAdolescent refugee girls lack adequate SRH information, experience poor SRH outcomes including school absence due to menstruation, sexual violence and FGM. Comprehensive SRH services including sexuality education, barrier-free access to SRH services and parental involvement are recommended.Electronic supplementary materialThe online version of this article (10.1186/s12978-019-0698-5) contains supplementary material, which is available to authorized users.

Malaria is a leading cause of pediatric mortality, and Uganda has among the highest incidences in the world. Increased morbidity and mortality are associated with delays to care. This qualitative study sought to characterize barriers to prompt allopathic care for children hospitalized with severe malaria in the endemic region of southwestern Uganda. Minimally structured, qualitative interviews were conducted with guardians of children admitted to a regional hospital with severe malaria. Using an inductive and content analytic approach, transcripts were analyzed to identify and define categories that explain delayed care. These categories represented two broad themes: sociocultural and structural factors. Sociocultural factors were 1) interviewee's distinctions of “traditional” versus “hospital” illnesses, which were mutually exclusive and 2) generational conflict, where deference to one's elders, who recommended traditional medicine, was expected. Structural factors were 1) inadequate distribution of health-care resources, 2) impoverishment limiting escalation of care, and 3) financial impact of illness on household economies. These factors perpetuate a cycle of illness, debt, and poverty consistent with a model of structural violence. Our findings inform a number of potential interventions that could alleviate the burden of this preventable, but often fatal, illness. Such interventions could be beneficial in similarly endemic, low-resource settings.

BackgroundIn the treatment and safe service delivery of each disease, it is very important to understand the perceptions of caregivers and patients where they are not well understood because different cultures, regions and ethnicities have different ways how they understand the concept therefore this study aimed at understanding how patients and caregivers perceive Alzheimer’s and related dementias and their coping strategies in south western Uganda.Methods A qualitative cross sectional study was conducted using purposive sampling and 18 and 12 caregivers and patients were recruited respectively where in-depth interviews were conducted and data was analyzed using ATLAS Ti software.Results Five broad themes were used from Kleinmans explanatory model from both 2 objectives which included perceived identity, causes, treatment, effects and coping strategies. Participants had different views about each category. A big number was able to identify the disease as forgetfulness and the perceived causes included physical, psychological, and witch craft and most of caregivers continued to say that this disease does not need treatment since the most cause of it is aging which is a natural process while treatment was only sought secondary after going to the health facility for another cause/disease. The effects on caregivers include strain financial constraint, poor health while patients complained of non-productivity, psychological/emotional torture and lack of independence. In the instance of coping strategies more caregivers had options of seeking help from relatives, community based organizations (CBO) while some had no option but to just believe God.Conclusion Study findings reveal that caregivers and patients of Alzheimer’s and related dementias have both positive and negative perceptions. The negative perceptions lie more on treatment options and these may affect service delivery and reduce patient’s life span when the right treatment is not thought. Therefore continuous community sensitization about the disease is needed more.