Utilization of sexual and reproductive health services among young people in refugee settings in Uganda

Bukuluki, Paul; Wandiembe, Symon Peter; Kiwujja, Victor; Kajungu, Christine; Mugwanya, Wilberforce; Nabakooza, Shakira; Anyii, Cyprian; Kaikai, Fiona

doi:10.3389/frph.2023.1077761

Cited by 3 publications

References 34 publications

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Understanding the demographic and socioeconomic determinants of morbidity in Eastern Uganda: a retrospective analysis of the Iganga-Mayuge health and demographic surveillance data

Cygu,

Nabukeera,

English

et al. 2024

bmjph

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IntroductionUnderstanding the determinants of disease burden is imperative in enhancing population health outcomes. This study uses data from the Iganga-Mayuge Health and Demographic Surveillance Site, to understand demographic and socioeconomic factors influencing morbidity.MethodsWe analysed secondary data from 2018 to 2023. We employed graphs and tables to present morbidity patterns across different sociodemographic factors and applied mixed-effects multinomial multivariate logistic regression model to understand the correlates of morbidity.ResultsThe findings reveal a predominant prevalence of malaria, lower respiratory tract infections, coryza, gastric acid-related and urinary tract infections, collectively constituting 83% of diagnosed diseases. Noteworthy demographic variations, particularly gender and age, significantly impact disease distribution, revealing higher diagnosis rates among females. Additionally, socioeconomic factors, including education and wealth status, contribute to discernible differences in disease burden.ConclusionThis research provides crucial insights into the implications of demographic and socioeconomic factors on disease burden in Uganda. The results contribute to evidence-based policy-making, highlighting the necessity for targeted interventions addressing specific health challenges encountered by diverse populations. The study advocates for continuous assessment of the epidemiological landscape to inform more tailored and effective health strategies, ultimately enhancing resilience in disease control efforts.

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Understanding the demographic and socioeconomic determinants of morbidity in Eastern Uganda: a retrospective analysis of the Iganga-Mayuge health and demographic surveillance data

Cygu,

Nabukeera,

English

et al. 2024

bmjph

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Process evaluation of comprehensive sexuality education programme in Zambia: a focus on contextual factors, mechanisms of impact, quality of development and implementation process

Mukanga,

Dlamini,

Taylor

2024

BMC Health Serv Res

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Background Comprehensive sexuality education (CSE) is critical in addressing negative sexual and reproductive health (SRH) outcomes among adolescents. Yet in many low- and middle-income countries (LMICs) including Zambia, little is known about the impact, realities of CSE implementation, the quality of teaching and the comprehensiveness of the content covered. Methods Our approach was informed by a process evaluation incorporating recommendations by the European Expert Group guidance on evaluating sexuality education programmes and the Medical Research Council (MRC) guidelines on process evaluation. The development process and quality of CSE implementation were assessed using eight and six quality criteria respectively. In-depth interviews (IDIs), focus group discussions (FGDs), document analysis and classroom observation were employed to assess contextual factors, implementation process and mechanisms of impact of CSE. In-depth interviews (50) and focus group discussions (2) with seven pupils in each group were conducted among 64 purposefully selected participants. The sample comprised pupils (35), parents (4) and teachers (17) from nine secondary schools (four peri-urban, four urban and one rural), policymakers (4), and religious leaders (4). We employed deductive content analysis to analyse the data. Results Contextual factors that influenced the implementation of CSE included: (1) piecemeal funding for the CSE programme; (2) lack of monitoring programmes in schools; (3) lack of community engagement; (4) religious and socio-cultural barriers; (5) lack of skills and competency to teach CSE; and (6) insufficient time allocation for CSE. The assessment of the quality of the development of CSE revealed: (1) a lack of sexual diversity; (2) no meaningful participation of pupils in programme implementation; (3) a lack of stakeholder engagement during programme implementation; (4) lack of gender sensitivity; and (5) lack of human rights approach. Assessment of the quality of the implementation of CSE revealed: (1) no evidence of skill-based CSE teaching; (2) no linkage between CSE and SRH services in the communities; and (3) a lack of incorporation of multiple delivery methods during CSE teaching. The mechanisms of impact of CSE were related to the acceptability and positive changes in pupils’ SRH practices. Conclusion The complex influences of contextual factors during CSE implementation highlight the need for contextual analysis during the interventional design. Co-creation of the CSE programme through stakeholder participation could reduce social opposition and enable a culturally sensitive CSE. Comprehensive teacher training, a guiding curriculum as well as setting of appropriate monitoring tools and indicators are likely to enhance the quality of CSE implementation.

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Knowledge, attitudes and factors associated with the utilization of youth- friendly sexual and reproductive health services among teenagers and young adults in Kigali city, Rwanda

Nyirarukundo,

Venuste,

Nsangiyumva

et al. 2024

Preprint

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Background Youth-friendly sexual and reproductive health services (YFSRHSs) play a paramount role in supporting the physiological, cognitive, emotional, and social evolution of young people into healthy and productive adults. In Rwanda, services are provided by health facilities with trained healthcare providers and youth centers where young people are additionally equipped with short professional courses such as welding, cooking, football, and computer literacy, among others. This study was conducted to assess knowledge and attitudes toward YFSRHS and determine the factors associated with their use among non-married or cohabiting teenagers and young adults (TYAs) aged 15–24 years. Methods This was a cross-sectional survey in which data were collected from July 8 to 22, 2024. The collected data were analyzed via STATA version 17. A generalized estimating equation (GEE) model was used to identify factors associated with the utilization of the YFSRHS. Statistical significance was assumed at a p value less than 0.05. Setting: Data were collected in three districts of Kigali city in Rwanda, Eastern Africa. Results This study revealed that out of the 850 TYAs included in the study, both sexes were nearly equally represented: 49.4% females versus 50.6% males. The proportions of TYAs with adequate knowledge, positive attitudes, and practices were 76.9%, 70.0%, and 60.0%, respectively. The predictors of YFSRHS use include living in the Gasabo district [aOR:4 with 95% C. I: 2.5–6.1], being aware of the services [aOR:3.8 with 95% C. I: 2.3–6.2], having adequate knowledge of YFSRHS [aOR: 2.6 with 95% C. I: 1.7–3.9], being a student in a school located near lodges/guest houses [aOR:1.6 with 95% C. I: 1.0–2.6], being female [aOR: 1.6 with 95% C. I: 1.1–2.3], being cared for by a father [aOR:2.4 with 95% C. I: 1.4–4.1] or a mother only [aOR: 1.8 with 95% C. I: 1.8–2.7], and having positive attitudes toward YFSRHS [aOR: 1.8 with 95% C. I: 1.2–2.7]. Furthermore, the number of TYAs who ever used YFSRHS was 2.2 [aOR: 2.2 with 95% C. I: 0.9–5.1] times more likely to be using contraceptives, and 2.4 [aOR:2.4 with 95% C. I: 1.6–3.4] more likely to have been tested for HIV than those who were not. Conclusion Despite the apparent benefits of YFSRH in increasing the uptake of HIV testing and contraception services among TYAs in Kigali city, their use remains low, mainly due to a lack of adequate knowledge, which in turn affects the positive attitudes of TYAs toward YFSRHS, especially among males. Thus, efforts aimed at increasing the utilization of services should focus on increasing awareness of TYAs in services, with a particular emphasis on males and those at greater risk of HIV and unintended pregnancies.

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Utilization of sexual and reproductive health services among young people in refugee settings in Uganda

Cited by 3 publications

References 34 publications

Understanding the demographic and socioeconomic determinants of morbidity in Eastern Uganda: a retrospective analysis of the Iganga-Mayuge health and demographic surveillance data

Understanding the demographic and socioeconomic determinants of morbidity in Eastern Uganda: a retrospective analysis of the Iganga-Mayuge health and demographic surveillance data

Process evaluation of comprehensive sexuality education programme in Zambia: a focus on contextual factors, mechanisms of impact, quality of development and implementation process

Knowledge, attitudes and factors associated with the utilization of youth- friendly sexual and reproductive health services among teenagers and young adults in Kigali city, Rwanda

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