Background: Globally, overall prevalence of caesarean section (CS) is estimated at 18.6%, with 27% in high-income countries and 6% in low- and middle-income countries. There is an increase in trends of CS in Uganda from 8.5% in 2012 to 11% in 2016. There have been no studies done to account for the high rates of CS in a rural hospital in Uganda. This study determined the proportion and factors associated with CS delivery at a rural hospital in south western Uganda.Methods: This was a cross sectional study of 321 immediate postnatal women in a rural hospital in south western Uganda. A structured questionnaire and data abstract forms were used to collect information on proportion and factors associated with CS. Eligible participants were enrolled consecutively. Logistic regression analysis was done to identify the factors associated with CS taking into account potential confounders.Results: This study recruited 321 women with mean age of 25.8 ±6.086 years, mean parity 2.6 ±1.673 and mean antenatal care visits of 4.27 ±1.197. The proportion of CS in this study was 38.3% (123/321). Of these, 110 (89.4%) were emergencies and 27(10.6%) electives. Only 8.4% of the respondents were referrals. The commonest indications of CS were fetal distress (28.5%), history of previous CS (18.7%) and poor progress of labour (11.4%). No factors were significantly associated with CS in this study.Conclusion: There is a high proportion of CS in a rural hospital in Uganda and this is three times higher than the WHO recommended CS rates. Majority of CS are emergencies due to fetal distress and poor progress of labour. There is a need for additional studies exploring the reasons for the much higher than expected CS rates.

Background: The World Health Organization (WHO) defines a stillbirth as a baby born with no signs of life at or after 28 weeks' gestation. In high income countries, it is evident that a new-born will survive after 25 weeks' gestation, compared to 28-32 weeks' gestation in low resource countries. The global stillbirth rate is estimated to be 13.9 still births per 1000 total births. In Africa, the still birth rate is 10 times that of the developed countries, indicating 29 births Vs 3 per 1000 live births. This paper recounts women's experiences following the delivery of a Stillbirth. Materials and Methods: The study used a Phenomenological study design to describe the essence of the women's experiences following the delivery of a Stillbirth. The study focused on 16 women aged 17-35, who had experienced stillbirths both macerated and fresh, these were the primary sources of information for the study. The in-depth interviews held with participants revealed that the stillbirth Phenomenon has a major negative impact on the reproductive health lives of women and the magnitude of grief and the associated mysteries surrounding stillbirth make the whole experience unbearable. The paper looks at the short and long term experiences of birthing a silent baby and the different strategies used by women to cope with the experience. Findings: The Stillbirth Phenomenon has a major negative impact on the reproduction lives of women. The magnitude of grief and the associated mysteries surrounding stillbirth make the whole experience unbearable. Women experience untold grief from the loss, coping with the sad memory of loss for all their life and at time with little or no support. Conclusion: Although they always come up with self-coping mechanisms, there is a need to provide psychological and social support to these mothers who have experienced a still birth. The findings from this study show the physical, social and psychological challenges women endure during the occurrence of the stillbirth phenomenon. These findings can be used to inform efforts aimed at providing support to women who fall victim of stillbirth so as to make the experience less painful. The findings will also pave way for more research on experiences of women following Stillbirths events and other silent tragedies impacting maternal health in the country and the world at large.

Background Hypertension is an important worldwide public-health challenge because of its high prevalence and for being a risk factor for cerebrovascular, cardiovascular and chronic renal disease. Despite these risk factors, blood pressure control among hypertensive patients is still poor. Objectives To assess dietary and lifestyle factors associated with uncontrolled blood pressure control among a series of Ugandan hypertensive patients under care at a Kiruddu hospital.Methods A cross sectional study involving 271 adult hypertensive patients attending general outpatient hypertensive clinic were enrolled. We collected data on dietary and lifestyle factors, social demographics, BMI, comorbidities, and adherence to hypertensive medication. Dietary factors were based on recommended DASH diet including nine food items salt; grains; fruits; vegetables; nut/seeds, and legumes; dairy; meat; fat; and sweets. Questionnaires on alcohol intake, smoking status and level of physical activity were also administered. An average of the previous two Blood pressure readings were recorded while weight and height were measured for each subject at enrolment. Factors associated with uncontrolled blood pressure (>140/90mmHg) were assessed using a multivariate logistic regression model.Results The mean age of study participants was 57 years (SD ± 0.76 years), with female dominance (77.9%). Among the study participants, 121 (44.7%) had uncontrolled BP. Dietary factors that remained significantly associated with uncontrolled blood pressure with adjusted OR (95%CI) included consumption of raw salt: 4.18 (1.32-13.24) and inadequate fruit consumption (less than 7days/week): 2.18 (1.26-3.75) while clinical factors included being overweight: 2.51 (1.27-4.95) and poor adherence to antihypertensive medications prescribed: 1.82 (1.03-3.21).Conclusion The proportion of hypertensive patients with uncontrolled BP was high (44.7%). Consumption of raw salt, inadequate fruit consumption being overweight and poor adherence to antihypertensive medication were significantly associated with uncontrolled BP. From these findings, many of the factors that impact on the control of blood pressure are fortunately modifiable.