Kampala Capital City Research Articles

Enhancing Change Management for Improved Public Service Delivery: A Study of Kampala Capital City Authority (KCCA)

Purpose: This study aimed to investigate the role of change management in improving service delivery within government parastatals in Uganda, specifically focusing on the Kampala Capital City Authority (KCCA). It explored the enabling factors for change management on service delivery and assessed the effects of change management on service delivery within these parastatals. Methodology: The study employed a cross-sectional and exploratory approach, utilizing both quantitative and qualitative methods. The study population consisted of 298 participants from various departments within KCCA. Data collection methods included self-administered questionnaires, interviews with key informants, and documentary reviews. The study instruments were validated using the Content Validity Index, and reliability was assessed using Cronbach’s Alpha coefficient. Quantitative data were analyzed using descriptive statistics, correlation analysis, and bivariate regression, while qualitative data were analyzed through content analysis. Findings: The study concluded that the enabling factors for change management on service delivery in government parastatals in Uganda are not well understood. Additionally, it found that change management does have a significant impact on service delivery within these institutions. Unique contribution to theory, practice and policy (recommendations): Based on the conclusions, it is recommended that KCCA administrators enhance service delivery through a more holistic approach to change management. This should involve addressing various enabling factors and components of the change management framework to optimize service delivery outcomes.

Developing an Ideal Change Management Framework for Enhancing Service Delivery in Government Parastatals: A Case Study of Kampala Capital City Authority in Uganda.

Purpose: This study aims to develop an ideal change management framework specifically tailored to government parastatals in Uganda, focusing on the Kampala Capital City Authority (KCCA), to enhance service delivery. Methodology: The research adopted a cross-sectional and exploratory approach, utilizing both quantitative and qualitative methods. The study population comprised 298 participants from various departments within KCCA. Data collection involved self-administered questionnaires, interviews with key informants, and documentary review. Validation of study instruments was conducted using the Content Validity Index, and reliability was assessed through Cronbach’s Alpha coefficient. Quantitative data were analyzed using descriptive statistics, correlation analysis, and bivariate regression, while qualitative data underwent content analysis. Findings: The study concluded that the change management process for service delivery in government parastatals in Uganda is well-defined. However, the ideal change management framework necessary for improving service delivery among these parastatals remains unidentified. Recommendations: Based on the findings, it is recommended that KCCA administrators adopt a more holistic approach to change management, addressing various enabling factors and components necessary to enhance service delivery effectively.

An Analysis of User Perceptions Towards Public Parking Management in Kampala City

The parking problems in Kampala City have become more pronounced due to the increasing vehicle numbers resulting from a growth in population and income levels. Understanding public perceptions and the various stakeholders’ parking needs and preferences is fundamental for identification of priority areas for improvement. This paper assessed the user perceptions of public parking management and the parking needs and preferences for various stakeholders in Kampala City. The study was evaluative and employed a cross sectional research design with a range of data diverse triangulation quantitative and qualitative techniques. From 328 questionnaires, participants were asked to assess fifteen (15) public parking management attributes from a point of view of their satisfaction. Also, a public parking stakeholder analysis was done and the level of influence by each stakeholder category in regards to parking management in the city and their parking needs and preferences were established. The study results revealed- that the customer satisfaction Index (CSI) of parkers was 52.4% indicating a relatively lower satisfaction level of the parking management in Kampala. From the fifteen public parking management attributes, four (4) of them to include affordability of parking, availability of parking spaces, accessibility to parking spaces and as well Safety and security were accorded the greatest importance. While thirteen (13) public parking stakeholders in Kampala City that included Ministry of Works and Transport (MoWT), Kampala Capital City Authority (KCCA), Multiplex Limited, Private Parking suppliers, public transport operators, Business Community, Commuters, Private Car Drivers, Logistics Vehicles, Traffic Police, Residents, shoppers and tourists and the academia were identified. The study recommends prioritization of those factors that parkers deem very important by the relevant authorities, stakeholder involvement in parking planning and management, establishment of an efficient enforcement and control mechanism, having a public parking vision with clear goals and objectives and as well the use of technology to enhance efficiency for both parkers and parking suppliers.

Coping mechanisms and strategies adopted to improve the quality and timeliness of immunization data among lower-level private-for-profit service providers in Kampala Capital City, Uganda.

Lower-level urban private-for-profit health service providers are actively engaged in the delivery of immunization services. However, not much is known about their everyday endeavours to improve data quality and ensure the submitted data meets the quality and timeliness requirements as per established guidelines. The objective of this paper was to examine the coping mechanisms and strategies adopted to improve the quality and timeliness of immunization data among lower-level private-for-profit service providers in Kampala Capital City, Uganda. A qualitative study design was adopted with in-depth interviews (n = 17) and key informant interviews (n = 8) completed among frontline health workers, district health managers and immunization implementing partners. Analysis followed a thematic approach with coding conducted using Atlas. ti, a qualitative data management software. Overall, coping mechanisms and strategies adopted to improve the data quality among lower-level urban private-for-profit immunization service providers included; Experiential attachment for practical skills acquisition in data management, data quality peer-to-peer learning among private-for-profit immunization service providers, registration using cohort system for easy tracking of records during subsequent visits, separation of visiting service user records from regular attendants, service delivery modifications such as reward for better performance, engagement of Village Health Teams (VHTs) in outreaches and data completion, and data quality checks through review of monitoring charts to identify gaps in data quality. Within the urban context, the delivery of immunization services by lower-level private-for-profit services faces data quality challenges some of which stem from the implementation context. Different coping strategies focusing on frontline health worker skills, enhanced experience sharing through peer-to-peer learning, modifications to registration and routine review of monitoring charts. However, these efforts were often faced with chronic barriers such as the high staff turnover calling for dedicated efforts to optimize the available implementation opportunities like guidelines mandating the public health facilities to supervise the lower-level private immunization service providers within their catchment areas to respond to the identified gaps.

Personal Exposure assessment to Particulate Matter among school children in Kampala Capital City in Uganda

Personal Exposure assessment to Particulate Matter among school children in Kampala Capital City in Uganda

The Challenges and Way Forward of Pollution: A Case Study of Makindye Division, Kampala Capital City

The Challenges and Way Forward of Pollution: A Case Study of Makindye Division, Kampala Capital City

Quality improvement interventions targeting immunization data from urban lower-level private-for-profit health service providers in Kampala Capital City: processes and implementation experiences

BackgroundLower-level private-for-profit urban immunization service providers contribute immensely to service delivery and data generation which informs evidence-based planning for the delivery of equitable immunization services within the urban context. And yet, current efforts tend to over-concentrate on supporting the public health sector. We conducted this implementation research study in a bid to contribute to improvements in the accuracy and timeliness of immunization service data among lower-level private-for-profit immunization service providers within Kampala Capital City of Uganda.MethodsA quasi-experimental design was adopted with a participatory process leading to the identification of two poor-performing city divisions where the intervention was implemented. Forty private health facilities participated in the implementation research with 20 assigned to the intervention while the other 20 were assigned to the control. Performance measurements were assessed at baseline and end-line to compare outcomes between the intervention and control groups.ResultsThrough a theory-driven design with the COM-B as the guiding model, the behavioural change intervention functions targeted to cause the desired change leading to improvements in data quality among private providers were; (1) training, (2) modelling, (3) persuasion, (4) education, (5) environmental restructuring, (6) enablement and (7) coercion. In combination, they were primed to contribute to improvements in skills and approaches to data handling while maintaining of a close oversight function.ConclusionsThe applied intervention components were preferred for their contextual applicability within the urban private immunization service delivery settings with a likelihood of sustaining the gains for some time.

Role of Lifestyle Risk Factors for Azoospermia: Insights from Ebenezer Clinical Laboratory - Kampala Capital City, Uganda

Background: Azoospermia is one of the social problems affecting families/countries today in the whole world, which has resulted in an involuntary declining birth rate [1]. Worldwide, more than 70 million couples suffer from infertility, and it is estimated that azoospermia is found in up to 10 to 20 percent of the men who present to an infertility clinic [2]. Uganda is among the countries where male infertility is assumed to be a big challenge, with an estimated 5,000,000 people facing infertility, where 10 to 15% of the couples are unable to have children. Hence the current study aimed at establishing the risk factors associated with azoospermia among patients attending Ebenezer Clinical Laboratory, Kampala, Uganda. Methods: A retrospective case-control study design was conducted on men who had visited the Microbiology Department for semen analysis from 1st January to 31st December 2015. Cases were azoospermic participants in the ECL database with no sperm cells in the ejaculate whereas controls were normozoospermic participants in the ECL database with normal sperm cells in the ejaculate. Systematic sampling was employed in the selection of respondents using their clinical records. The sample size was 204 (102 cases and 102 controls) clients, determined using a formula from the OpenEpi software package for Kelsey. The sample involved 102 cases and 102 with a ratio of cases to controls being 1:1. The study used a data abstraction structured questionnaire for data collection. Data was analyzed using descriptive statistics to generate frequencies and percentages. Chi-square test and logistic regression analyses were used to determine whether there was a significant association between risk factors and azoospermia with about 0.05 statistical significance. Results: The study found out that tobacco use [AOR = 11.245, (CI 95% = 3.913 – 32.312), p = 0.000], marijuana use [AOR = 21.975, (CI 95% = 5.710 -44.571), p = 0.000], type of underwear [AOR = 9.366, (CI 95% = 4.360 – 19.9471), p = 0.000] were statistically significant factors associated with azoospermia among patients Conclusions: Interventions should be focused on improving these factors, such as minimizing tobacco and marijuana usage among the populations, as well as sensitizing the males on the dangers of wearing tight underwear.

The Effects of Central Government Financial Allocation on the Provision of Quality Maternal Health Care in Kampala City

The relationship between devolution and service delivery has been a matter of inquiry for the past three decades. This paper aimed to examine the impact of Central Government financial allocation on the quality of delivery of maternal healthcare services in Kampala City, Uganda. To achieve this, a case study design incorporating both qualitative and quantitative methods was employed. Data collection involved the use of questionnaires and interviews conducted among healthcare professionals, KCCA (Kampala Capital City Authority) staff, and mothers receiving maternal healthcare at selected public health centers. The gathered data underwent both qualitative and quantitative analyses using measures of central tendency such as mean, standard deviation, correlation, and regression analysis. The results of regression analysis indicated that Central Government financial allocation had a significant influence on the provision of quality maternal healthcare. In light of these findings, it is recommended that steps be taken to enhance Central Government financial allocation. Additionally, the administration of KCCA should consider implementing anti-corruption measures as part of their best practices. Furthermore, healthcare center leadership and KCCA leadership should prioritize effective planning, good governance, and transparency in their financial expenditure and operations.

Factors Influencing Recentralization of Local Government Functions in Uganda

The decentralisation system of governance is perceived as one of the recent public sector reforms to improve service delivery in Uganda. It is the transfer of authority from Central to Local Governments to execute their duties to improve service delivery. Various developing countries have praised Uganda’s decentralisation policy regarding the magnitude of the transfer of authority to the local level. However, since 2003, the Central Government started reversing the policy in terms of : recentralization of the appointment of Chief Administrative Officers and Municipal Town Clerks and of recent City Town Clerks (for new cities in Uganda) from the District Service Commissions (DSCs) to the Public Service Commission, recentralization of Kampala Capital City Authority (KCCA) under the management of the Executive Director, Procurement of drugs from the district health office to the National Medical Stores (NMS), recentralization of the payroll and the recent recentralization of local revenue collection from LGs. This paper focuses on the factors influencing the recentralization of Local Government powers in Uganda. This is presumed to be evidence of the demise of decentralisation policy. From the reviewed articles, these factors include: accountability challenges, human resource management crisis, political interference by local authorities and lack of financial discipline among local authorities and fear of local autonomy. The paper concluded that recentralisation of Local Government functions reduced undue influence of local politicians though it accorded excessive powers to executive officers in Local Governments; human resource crisis was mainly caused by poor man power planning. Recentralisation of local revenue caused financial constraints at the local level and recentralisation of KCCA led to the weakening of the opposition but led to increases resources to develop the capital city. The paper recommended that the Parliament should harmonise with the central government on the issue of returning Local revenue collection and management at the local level; give reasonable powers to the local Governments to control top technical leadership; increase funding to Central Government staff to monitor Local Government programs and build the capacity of local leaders to improve service delivery

Use of a toll-free call center for COVID-19 response and continuity of essential services during the lockdown, Greater Kampala, Uganda, 2020: a descriptive study.

on March 21, 2020, the first case of COVID-19 was confirmed in Uganda. A total lockdown was initiated on March 30 which was gradually lifted May 5-June 30. On March 25, a toll-free call center was organized at the Kampala Capital City Authority to respond to public concerns about COVID-19 and the lockdown. We documented the set-up and use of the call center and analyzed key concerns raised by the public. two hotlines were established and disseminated through media platforms in Greater Kampala. The call center was open 24 hours a day and 7 days a week. We abstracted data on incoming calls from March 25 to June 30, 2020. We summarized call data into categories and conducted descriptive analyses of public concerns raised during the lockdown. among 10,167 calls, two-thirds (6,578; 64.7%) involved access to health services, 1,565 (15.4%) were about social services, and 1,375 (13.5%) involved COVID-19-related issues. Approximately one-third (2,152; 32.7%) of calls about access to health services were requests for ambulances for patients with non-COVID-19-related emergencies. About three-quarters of calls about social services were requests for food and relief items (1,184; 75.7%). Half of the calls about COVID-19 (730; 53.1%) sought disease-related information. the toll-free call center was used by the public during the COVID-19 lockdown in Kampala. Callers were more concerned about access to essential health services, non-related to COVID-19 disease. It is important to plan for continuity of essential services before a public health emergency-related lockdown.

Impact of Leadership Styles on Government Construction Project Success: A Structural Equation Modeling Approach

Government construction projects play an important role in both developed and developing countries. They contribute about 80% of total capital assets, 10 % of GDP, and more than 50% of the wealth invested in fixed assets and employment opportunities. As such, several countries like Sweden in Europe, Indonesia in Asia, South Africa and Kenya in East Africa have invested heavily and succeeded in construction projects. Similarly, Uganda has also invested heavily in construction projects; however, most of these projects have been unsuccessful, yet projects contribute to economic development. This study aimed to determine the contribution of leadership styles to the success of government construction projects in Uganda. The study was cross-sectional with a quantitative research design. A self-administered questionnaire was used to collect data from a sample of 100 Kampala Capital City Authority construction projects from a population of 120 projects that were stratified according to the five divisions of Kampala district. Four respondents were selected from each of the 100 projects selected, resulting in a total of 400 respondents for the study. Structural Equation Modelling was conducted using SPSS. Results show that leadership styles, especially communication and participation are positively and significantly associated with government construction project success. Therefore, government project managers should communicate effectively and involve stakeholders at every stage of the project cycle to realise project success. It is recommended that the path-goal theory be adopted for replicating the study. Also, government ministries must adopt the proposed model as it is a valuable resource for researchers and practitioners, especially those involved in government construction projects. Similarly, the government, through the Ministry of Works and Transport, should constantly remind government project managers to ensure adequate internal and external communication and allow the participation of stakeholders during the implementation of government projects. Keywords Communication, Government Construction Projects, Leadership styles, Participation, Project Success, Structural Equation Modeling, Uganda

Assessment of Enrofloxacin Usage and Residue Levels of Enrofloxacin-Ciprofloxacin in Breast and Liver Tissues of Commercial Broilers Sold in Kampala-Uganda.

Human exposure to veterinary drugs like fluoroquinolones occurs due to the presence of their residues in foods from animal sources in varying concentrations. The existence of antibiotic residues in foodstuffs can pose great public health problems to consumers. This study aimed to assess enrofloxacin use patterns and assess residue levels of enrofloxacin/ciprofloxacin in breast muscle and liver tissues of broiler chickens sold for consumption in Kampala capital city. This was a cross-sectional study that involved both field survey and laboratory-based methods. The field study involved the use of qualitative and semi-quantitative data collection tools to interview 34 broiler farmers and 10 veterinary drugs vendors. For the determination of enrofloxacin/ciprofloxacin levels, 68 chicken breast and liver tissue samples were collected from main markets in Kampala over one month and analyzed using HPLC-UV. Enrofloxacin was the most used antibiotic (100%) for the management of poultry diseases, majorly respiratory diseases (100%), salmonella infections (40%), and disease prevention (60%). Over 76% of the farmers knew the meat withdrawal time (WDT) for enrofloxacin, but none of them adhered to this. Over 70% of the farmers reported that the veterinary drugs vendors were not providing meat WDT information. Enrofloxacin/ciprofloxacin residues were identified in 35.3% (12/34) of the muscle and 38.2% (13/34) of the liver tissues analyzed. Of those muscle and liver tissue samples that tested positive, 25% (3/12) and 38.5% (5/13) respectively had drug concentrations higher than the recommended Maximum Residue Limits. The overall mean enrofloxacin/ciprofloxacin concentration in the chicken muscle and liver tissues was 83.6 (±34.5) µg/kg and 171.5 (±75.9) µg/kg. This observed presence of enrofloxacin/ciprofloxacin levels above safety requirements is attributable to inadequate medicines use information provided by veterinary drugs vendors to farmers and also to the non-compliance of some farmers to meat WDT due to the economic implications.

Aflatoxin exposure and risk assessment among peri-urban low income population in Kampala Capital City, Uganda

Kampala Capital City (KCC) is home to over 3.7 million residents majority of whom are low -income earners who depend on low-cost cereals and legumes for food. These foods are mainly purchased from retail shops and open markets that expose them to mould and aflatoxin contamination. This study assessed total aflatoxin exposure arising from consumption of maize and groundnuts based products by KCC dwellers, and the associated cancer risk. The study was conducted in two divisions of KCC targeting mothers (15–49 years) and children (6–59 months). Results indicate that the majority of the household heads were engaged in low-income occupations with 35 % earning less than US $ 1 a day. Over half of the households purchased cereals and legumes once to twice a week and stored the food in polypropylene or polythene bags. The mean maize consumption rate was 128.7 and 189.9 g/person/day for children and mothers, respectively, while that for groundnuts was 71.6 (children) and 110 (women) g/person/day. Groundnut flour samples recorded the highest proportion (76 %) of samples that tested positive for aflatoxins with a mean total of 37.94 µg/kg (0.04 - 296.4 µg/kg). Only 28 % of the maize flour samples tested positive with a mean total of 27.9 µg/kg (0.04 - 345.8). The mean total aflatoxin levels in both maize (27.9 µg/kg) and groundnuts (37.94 µg/kg) were above the minimum regulatory limit of 10 µg/kg set by the Uganda National Bureau of Standards. The estimated total aflatoxin intake ranged between 0.01 and 0.91 µg/kg/BW/day in both women and children while the estimated total aflatoxin exposure was above the daily intake limit of 0.017 µg/kg BW/day recommended by the European Food Safety Agency. The derived risk of developing primary liver cancer was 5.4 and 7.6 cancer cases per 100,000 individuals per year for children 6–59 months and mothers 15–49 years respectively. The study findings suggest that consumption of maize and groundnuts based foods by low income dwellers in KCC is associated with health risks as it could lead to development of primary liver cancer. Interventions such as; sensitization of all value chain actors, enforcement of existing aflatoxin standards, and boosting household income to enhance household dietary diversity need to be put in place to reduce aflatoxin exposure and its related health risks.

The Actors' Symbiosis in the Recurrence of Slums after In-situ Housing Redevelopment Initiatives. Perspectives from Namuwongo Slum, Kampala City

This paper analyses the influence of various actors in the reoccurrence of slums in the city of Kampala, amidst the slum upgrading initiatives. This paper attributes such reoccurrence to the mismatch between the expectations of the actors involved in upgrading and the housing location mobility attributes of low-income households. This paper adopted a case study strategy, utilising a mixture of both qualitative and quantitative techniques. A total of 60 semi-structured questionnaires were issued to Namuwongo Slum Community, and only 52 were returned. Furthermore, 28 interviews were held. Six interviews targeted Local Council 1 chairpersons, 08 with officials from Slum Dwellers International (SDI), 04 with officials from the Ministry of Lands Housing and Urban Development (MLHUD), 03 with officials from Kampala Capital City Authority (KCCA), 04 privately practising land economists, and 03 private physical planners. From the information gathered, the influence of slum upgrading actors in the low-income household mobility and reoccurrence of the Namuwongo slum was exhibited through four thematic areas. These included: tracking the residential mobility tendencies, fit-for-purposeness of the upgrading programs/initiatives, actor coordination and the mismatch in expectation and preferences between the program actors and the low-income households. This paper, therefore argues that, actor coordination and participatory involvement of low-income slum-dwelling households enables the adequate fit-for-purposeness of the in-situ upgrading initiatives. This could also go a long way in limiting slum reoccurrence as the key drivers of household mobility would be understood and well incorporated in the programs.

Assessment of Household Air Pollution Exposure in Kampala Capital City, Uganda

Assessment of Household Air Pollution Exposure in Kampala Capital City, Uganda

SARS-CoV-2 seroprevalence among blood donors in Uganda: 2019-2022.

The true burden of COVID-19 in low- and middle-income countries remains poorly characterized, especially in Africa. Even prior to the availability of SARS-CoV-2 vaccines, countries in Africa had lower numbers of reported COVID-19 related hospitalizations and deaths than other regions globally. Ugandan blood donors were evaluated between October 2019 and April 2022 for IgG antibodies to SARS-CoV-2 nucleocapsid (N), spike (S), and five variants of the S protein using multiplexed electrochemiluminescence immunoassays (MesoScale Diagnostics, Rockville, MD). Seropositivity for N and S was assigned using manufacturer-provided cutoffs and trends in seroprevalence were estimated by quarter. Statistically significant associations between N and S antibody seropositivity and donor characteristics in November-December 2021 were assessed by chi-square tests. A total of 5393 blood unit samples from donors were evaluated. N and S seropositivity increased throughout the pandemic to 82.6% in January-April 2022. Among seropositive individuals, N and S antibody levels increased ≥9-fold over the study period. In November-December 2021, seropositivity to N and S antibody was higher among repeat donors (61.3%) compared with new donors (55.1%; p = .043) and among donors from Kampala (capital city of Uganda) compared with rural regions (p = .007). Seropositivity to S antibody was significantly lower among HIV-seropositive individuals (58.8% vs. 84.9%; p = .009). Despite previously reported low numbers of COVID-19 cases and related deaths in Uganda, high SARS-CoV-2 seroprevalence and increasing antibody levels among blood donors indicated that the country experienced high levels of infection over the course of the pandemic.

Strengthening Kampala's Urban Referral System for Maternal and Newborn Care Through Establishment of an Emergency Call and Dispatch Center.

Most pregnant women living in urban slum communities in Uganda deliver at public health centers that are not equipped to provide emergency obstetric and newborn care. When obstetric emergencies occur, pregnant women are referred to a higher-level facility and are responsible for arranging and paying for their own transport. The Kampala Slum Maternal Newborn (MaNe) project developed and tested an emergency call and ambulance dispatch center and a mobile application to request, deploy, and track ambulances. We describe the development of these 2 interventions and findings on the feasibility, acceptability, and sustainability of the interventions. MaNe conducted a mixed-method feasibility study that included an assessment of the acceptability and demand of the interventions. In-depth interviews (N=26) were conducted with facility proprietors, health providers, ambulance drivers, Kampala Capital City Authority officers, and community members to understand the successes and challenges of establishing the call center and developing the mobile application. Thematic content analysis was done. Quantitative data from the call center dispatch logs were analyzed descriptively to complement the qualitative findings. Between April 2020 and June 2021, 10,183 calls were made to the emergency call and dispatch center. Of these, 25% were related to maternal and newborn health emergencies and 14% were COVID-19 related. An ambulance was dispatched to transfer or evacuate a patient in 35% of the calls. Participants acknowledged that the call center and mobile application allowed for efficient communication, coordination, and information flow between health facilities. Supportive district leadership facilitated the establishment of the call center and has taken over the operating costs of the center. The call center and referral application improved the coordination of drivers and ambulances and allowed facilities to prepare for and treat cases more efficiently.

Maternal and newborn healthcare utilization in Kampala urban slums: perspectives of women, their spouses, and healthcare providers

BackgroundIt is assumed that the health conditions of urban women are superior to their rural counterparts. However, evidence from Asia and Africa, show that poor urban women and their families have worse access to antenatal care and facility childbirth compared to the rural women. The maternal, newborn, and child mortality rates as high as or higher than those in rural areas. In Uganda, maternal and newborn health data reflect similar trend. The aim of the study was to understand factors that influence use of maternal and newborn healthcare in two urban slums of Kampala, Uganda.MethodsA qualitative study was conducted in urban slums of Kampala, Uganda and conducted 60 in-depth interviews with women who had given birth in the 12 months prior to data collection and traditional birth attendants, 23 key informant interviews with healthcare providers, coordinator of emergency ambulances/emergency medical technicians and the Kampala Capital City Authority health team, and 15 focus group discussions with partners of women who gave birth 12 months prior to data collection and community leaders. Data were thematically coded and analyzed using NVivo version 10 software.ResultsThe main determinants that influenced access to and use of maternal and newborn health care in the slum communities included knowledge about when to seek care, decision-making power, financial ability, prior experience with the healthcare system, and the quality of care provided. Private facilities were perceived to be of higher quality, however women primarily sought care at public health facilities due to financial constraints. Reports of disrespectful treatment, neglect, and financial bribes by providers were common and linked to negative childbirth experiences. The lack of adequate infrastructure and basic medical equipment and medicine impacted patient experiences and provider ability to deliver quality care.ConclusionsDespite availability of healthcare, urban women and their families are burdened by the financial costs of health care. Disrespectful and abusive treatment at hands of healthcare providers is common translating to negative healthcare experiences for women. There is a need to invest in quality of care through financial assistance programs, infrastructure improvements, and higher standards of provider accountability are needed.

The Utility of Internet-Enabled Antibiotic Self-Medication and Its Associated Factors Among Patients Attending Private Clinics in Kawempe Division in Kampala Capital City, Uganda: Community-Based Cross-Sectional Study.

The expanding practice of internet-based antibiotic self-medication raises public health concerns as it increases antibiotic resistance and introduces avoidable risks. This study aims to examine the utility of internet-enabled antibiotic self-medication and its associated factors among patients attending private clinics in Kawempe division in Kampala Capital City, Uganda. This was an analytical cross-sectional study that enrolled participants attending private clinics in Kawempe Division's randomly selected zones. These were interviewed using a structured questionnaire, and the data were analyzed using STATA version 12 software. Logistic regression analysis was used, and variables with p ≤ 0.05 were considered as significantly associated with internet-enabled antibiotic self-medication. Out of the 313 respondents, 246 (79%) reportedly had ever used internet sources to self-medicate with antibiotics. Factors such as being male; single; had knowledge of antibiotics; believed that Internet should be used for antibiotic self-medication; Distance to the nearest medical center/hospital from your residence/workplace of about 5 km and residing near a drug shop/pharmacy that gives antibiotics without a prescription increased internet-enabled antibiotic self-medication. Furthermore, the variables of more than three household members; common practice of antibiotic self-medication in a household; did not agree that one can recover from the illness without a doctor's prescription and medical workers who did not explain adequately the antibiotics medication given for the illness decreased internet-enabled antibiotic self-medication. This study found that internet-enabled antibiotic self-medication practice is highly utilized and is associated with a variety of individual, household, and healthcare system factors. This necessitates strict adherence to national drug policy regulations governing antibiotic use. Furthermore, community health education is critical in combating such medication practices.