Uganda Demographic And Health Survey Research Articles

Prevalence, distribution and factors associated with modern contraceptive use among women of reproductive age in Uganda: evidence from UDHS 2016

BackgroundUnintended pregnancies pose significant health risks, particularly in sub-Saharan Africa, where millions of cases are recorded annually, disproportionately affecting adolescent women. Utilization of modern contraceptives is crucial in managing fertility and reducing unintended pregnancies, abortions, and associated health complications. This study aimed to assess the prevalence, distribution and factors associated with modern contraceptives utilization among women aged 15–49 in Uganda.MethodsThe study used secondary data from the 2016 Uganda Demographic and Health Survey (UDHS). The study sample comprise of 9,235 women aged 15–49 who used any method to prevent pregnancy in the five years preceding 2016 UDHS survey. The outcome variable for this study is utilization of modern contraceptives. Univariate, bivariate, and multilevel binary logistic regression was used to examine the relationship between individual and contextual factors on the modern contraceptive use among women aged 15–49 in Uganda. Choropleth mapping and network analysis in ArcGIS 10.8.2 was used to visualize spatial distribution of modern contraceptive use and measure community access to health facilities respectively.ResultsThe prevalence of modern contraceptive use was 53.19% (n = 4,919) in Uganda, with significant spatial variation by district. Higher prevalence (23.18%) was observed among women aged 20–29 compared to adolescents (4.1%). Only 21.9% of married women reported using modern contraceptives. At the individual-level, the factors that positively influenced use of modern contraceptives included: women’s marital status, wealth index and level of education while sex of the household head, ever terminated a pregnancy and religion negatively affected the use of modern contraceptives. At community-level, community access to health facilities was found to have negative influence on the use of modern contraceptives among women. In communities where women frequently visited health facilities in the 12 months preceding the survey, the use of modern contraceptives reduced by 3.9%. Accessibility analysis revealed challenges, with women in northeastern districts (rural districts) facing travel times exceeding four hours to reach health facilities.ConclusionUtilization of modern contraceptives are essential for promoting women’s health and well-being, particularly concerning maternal healthcare. This study highlights disparities in modern contraceptive use across age groups and the districts, emphasizing the need for targeted interventions. Policymakers and stakeholders must prioritize strategies that promote utilization of modern contraceptives and maternal healthcare services to address these disparities effectively. Such efforts are crucial for improving reproductive health outcomes and reducing the burden of unintended pregnancies and related complications in Uganda.

Does timing of sexual debut following menarche among female youth in Uganda matter? A discrete time analysis

BackgroundThe burden of early sexual engagement among youth is enormous. It directly raises the risk of sexually transmitted infections(STIs) and indirectly contributes to unintended pregnancy, unsafe abortion, premature childbirth, and psychosocial issues. The aim of this paper was to estimate the timing of sexual debut and examine the factors influencing the timing of first sexual intercourse following menarche among female youth aged between 15 and 24 in Uganda.MethodSelf-reported data were extracted from the 2016 Uganda Demographic and Health Survey (UDHS), with a sub-sample of 7964 female youth from the individual woman file. Kaplan-Meier survival curves, decrement life-table analysis, and the discrete-time logit model were used to examine the timing of sexual debut and associated factors.Results67.4% of the female youth had experienced first sexual initiation. Overall, the meantime to sexual debut was 4.4 years and the median time was 4.3 years, and all the female youth had experienced first sexual initiation by the end of the twelfth year following menarche. Significant factors found to influence the timing of sexual initiation include having higher education level (OR = 0.724: 95% CI = 0.59–0.89; p = 0.003), residing in the Northern region (OR = 0.877:95% CI = 0.79–0.97, p = 0.012), being employed (OR = 1.085: 95% CI = 1.01–1.16; p = 0.021), and being literate (OR = 1.155; 95% CI = 1.07–1.25; p < 0.001).ConclusionsThese findings are expected to be central in the bid to delay first sexual intercourse. Also they shed light on some of the factors associated with the timing of sexual debut which may be addressed at community level for non-school going youth and in schools, as school based prevention sexual and reproductive health programs. The findings highlight the need for future studies to collect more data to explore further the linkage between time to first debut since menarche and, mass media, religion, type of residence, and wealth index.

Individual and community-level factors associated with women’s utilization of postnatal care services in Uganda, 2016: a multilevel and spatial analysis

BackgroundOver time, Uganda has experienced high levels of maternal mortality (435 deaths per 100,000 live births in 2006 to 336 deaths per 100,000 live births in 2016). The persistence of high levels of maternal mortality jeopardizes the achievement of Sustainable Development Goal (SDG) 3.1, which calls for reducing maternal mortality to 70 deaths per 100,000 live births by 2030. Conversely, the utilization of postnatal care (PNC) services in Uganda remained very low and has varied across regions. This study examined the individual and community-level factors influencing women’s utilization of postnatal care services in Uganda.MethodsSecondary data from the 2016 Uganda Demographic and Health Survey (UDHS) were used in this study. The study population consisted of women aged 15 to 49 who reported giving birth in the five years preceding the 2016 UDHS survey. The factors associated with postnatal care services were identified using multilevel binary logistic regression and spatial analysis.ResultsThe result shows that the prevalence of postnatal care service utilization in Uganda was low (58.3%) compared to the World Health Organization (WHO) target of 100%. The univariate analysis shows that 13.7% of women were adolescents, 79% were of higher parity, and 70.4% had primary/no formal education, of which 76.6% resided in rural areas. On the other hand, the multilevel analysis results showed that women aged 20-29 years and 30-39 years were also found to be more likely to use PNC services (AOR = 1.2, 95% CI: 1.01-1.47). Women who received quality ANC (AOR = 2.1, 95% CI: 1.78–2.36) were more likely to use postnatal care services than their counterparts. At the community level, women who lived in media-saturated communities were more likely to use postnatal care services (AOR = 1.3, 95% CI: 1.01–1.65). The spatial analysis found that the Central, Eastern, and Northern regions were the areas of hotspots in the utilization of postnatal care services.ConclusionThis study found that age, parity, level of education, place of residence, employment status, quality of the content of antenatal care, and community media saturation were the predictors of postnatal care service utilization. The spatial analysis showed that the spatial distributions of postnatal care service utilization were significantly varied across Uganda. The government must expand access to various forms of media throughout the country to increase PNC utilization.

Equity in vaccine coverage in Uganda from 2000 to 2016: revealing the multifaceted nature of inequity

BackgroundThis study analyses vaccine coverage and equity among children under five years of age in Uganda based on the 2016 Uganda Demographic and Health Survey (UDHS) dataset. Understanding equity in vaccine access and the determinants is crucial for the redress of emerging as well as persistent inequities.MethodsApplied to the UDHS for 2000, 2006, 2011, and 2016, the Vaccine Economics Research for Sustainability and Equity (VERSE) Equity Toolkit provides a multivariate assessment of immunization coverage and equity by (1) ranking the sample population with a composite direct unfairness index, (2) generating quantitative measure of efficiency (coverage) and equity, and (3) decomposing inequity into its contributing factors. The direct unfairness ranking variable is the predicted vaccination coverage from a logistic model based upon fair and unfair sources of variation in vaccination coverage. Our fair source of variation is defined as the child’s age – children too young to receive routine immunization are not expected to be vaccinated. Unfair sources of variation are the child’s region of residence, and whether they live in an urban or rural area, the mother’s education level, the household’s socioeconomic status, the child’s sex, and their insurance coverage status. For each unfair source of variation, we identify a “more privileged” situation.ResultsThe coverage and equity of the Diphtheria-Pertussis-Tetanus vaccine, 3rd dose (DPT3) and the Measles-Containing Vaccine, 1st dose (MCV1) – two vaccines indicative of the health system’s performance – improved significantly since 2000, from 49.7% to 76.8% and 67.8% to 82.7%, respectively, and there are fewer zero-dose children: from 8.4% to 2.2%. Improvements in retaining children in the program so that they complete the immunization schedule are more modest (from 38.1% to 40.8%). Progress in coverage was pro-poor, with concentration indices (wealth only) moving from 0.127 (DPT3) and 0.123 (MCV1) in 2000 to -0.042 and -0.029 in 2016. Gains in overall equity (composite) were more modest, albeit significant for most vaccines except for MCV1: concentration indices of 0.150 (DPT3) and 0.087 (MCV1) in 2000 and 0.054 and 0.055 in 2016. The influence of the region and settings (urban/rural) of residence significantly decreased since 2000.ConclusionThe past two decades have seen significant improvements in vaccine coverage and equity, thanks to the efforts to strengthen routine immunization and ongoing supplemental immunization activities such as the Family Health Days. While maintaining the regular provision of vaccines to all regions, efforts should be made to alleviate the impact of low maternal education and literacy on vaccination uptake.

Family planning uptake and its associated factors among women of reproductive age in Uganda: An insight from the Uganda Demographic and Health Survey 2016.

Despite the government efforts to reduce the high fertility levels and increase the uptake of family planning services in Uganda, family planning use was still low at 30% in 2020 which was the lowest in the East African region. This study was undertaken to determine the prevalence and factors associated with the uptake of family planning methods among women of reproductive age in Uganda. This community-based cross-sectional study utilized secondary data from the Uganda Demographic and Health Survey (UDHS) of 2016. The survey data was downloaded from the Measure Demographic Health Survey website after data use permission was granted. Data was collected from a representative sample of women of the reproductive age group (15-49 years) from all 15 regions in Uganda. A total of 19,088 eligible women were interviewed but interviews were completed with 18,506 women. Data analysis was performed using SPSS statistical software version 32.0 where univariable, bivariable, and multivariable analyses were conducted. The prevalence of family planning use was found to be 29.3% and that of modern contraceptive use was found to be 26.6%. Multivariable analysis showed higher odds of current family planning use among older women (40-44 years) (aOR = 2.09, 95% CI: 1.40-3.12); women who had attained the secondary level of education (aOR = 1.91, 95% CI: 1.32-2.76); those living in households with the highest wealth index (aOR = 1.87, 95% CI: 1.29-2.72); and awareness of the availability of family planning methods (aOR = 1.41, 95% CI: 1.17-1.72). In conclusion, the study suggests improving women's education attainment, socio-economic position, and awareness may help increase use in the population.

Spatial variation and attributable risk factors of anaemia among young children in Uganda: Evidence from a nationally representative survey.

Anaemia continues to be a burden especially in developing countries that not only affects the physical growth and cognitive development of children but also increases their risk to death. Over the past decade, the prevalence of anaemia among Ugandan children has been unacceptably high. Despite this, spatial variation and attributable risk factors of anaemia are not well explored at national level. The study utilized the 2016 Uganda Demographic and Health Survey (UDHS) data with a weighted sample of 3805 children aged 6-59 months. Spatial analysis was performed using ArcGIS version 10.7 and SaTScan version 9.6. This was followed by a multilevel mixed-effects generalized linear model for the analysis of the risk factors. Estimates for population attributable risks (PAR) and fractions (PAF) were also provided using STATA version 17. In the results, intra-cluster correlation coefficient (ICC) indicates that 18% of the total variability of anaemia was due to communities within the different regions. Moran's index further confirmed this clustering (Global Moran's index = 0.17; p-value<0.001). The main hot spot areas of anaemia were Acholi, Teso, Busoga, West Nile, Lango and Karamoja sub-regions. Anaemia prevalence was highest among boy-child, the poor, mothers with no education as well as children who had fever. Results also showed that if all children were born to mothers with higher education or were staying in rich household, the prevalence would be reduced by 14% and 8% respectively. Also having no fever reduces anaemia by 8%. In conclusion, anaemia among young children is significantly clustered in the country with disparities noted across communities within different sub-regions. Policies targeting poverty alleviation, climate change or environment adaptation, food security as well interventions on malaria prevention will help to bridge a gap in the sub regional inequalities of anaemia prevalence.

Factors associated with Women’s timing of first antenatal care visit during their last pregnancy: evidence from 2016 Uganda demographic health survey

BackgroundUtilization of antenatal care services (ANC) during pregnancy has been recognized as a major public health intervention to abate maternal morbidity and mortality. Uganda has experienced high levels of maternal morbidity and mortality over the past two decades. This could be partly attributed to the lower proportion of women who initiated their first antenatal care visit during the first trimester of their gestation period. This study aimed at investigating the factors associated with timing of first ANC visit by women in Uganda.MethodThis study used secondary data from the 2016 Uganda Demographic and Health Survey (UDHS). The study population comprises of women aged 15–49 who reported to have given their last birth during the five years preceding the 2016 UDHS survey. The outcome variable for this study was the timing of first ANC visit. Univariate, bivariate, and multilevel binary logistic regression analysis was used to determine the factors associated with the utilization of timing of first ANC visit.ResultsFindings show that only 30% [95%CI; 0.28–0.31] of women utilized ANC during the first trimester. Women of higher parity (4+) were less likely to utilize ANC in the first trimester compared to the lower parity (1) (AOR, 0.74, CI; 0.60–0.92). Women who reside in communities with good access to health facility were more likely to utilize ANC during the first trimester as compared to women residing in communities inaccessible to health facility (AOR, 1.36, CI; 1.04–1.77). Women who reside in less diverse ethnic communities were less likely to utilize ANC in the first trimester compared to their counterparts (AOR, 0.15, CI; 0.11–0.22).ConclusionThis study demonstrated that contextual factors are important predictors of utilization of ANC during the first trimester apart from individual, factors. It is thus important for maternal health programme interventions to consider both individual and contextual factors when encouraging women to utilize ANC services during the first trimester.

Caesarean delivery in Uganda: Do non-clinical factors explain the trend?

The aim of this paper was to assess the association between non-clinical factors and Caesarean delivery in Uganda. Self-reported data from the individual recode file were extracted from the 2016 Uganda Demographic and Health Survey (UDHS), with a sub sample of 9929 women aged 15-49 with a recent birth in the last 5 years preceding the survey. Chi-square tests and multivariate comlementary log-log regression models were used to examine the relationship between non-clinical factors and Caesarean section delivery. About one in ten (7%) of the women aged 15-49 had Caesarean deliveries. Non-clinical factors which were significantly associated with Caesarean section delivery include advanced maternal age, having the first birth compared to subsequent births, having 1-3 children compared to 4 or more children, higher level of women's education relative to no education, being in the middle, richer, and richest wealth quintile compared to the poorest quintile. In conclusion, evidence suggests that the trend in Caesarean delivery can be attributed partially to non-clinical factors including advanced maternal age, birth order, parity, women's education level, and wealth quintile. Thus, efforts to address the trend in Caesarean section delivery, need to take account of non-clinical factors.

Analysis of risk factors associated with acute respiratory infections among under-five children in Uganda

BackgroundGlobally, infectious diseases are the major cause of death in children under the age of 5 years. Sub-Saharan Africa and South Asia account for 95% of global child mortalities every year, where acute respiratory infections (ARI) remain the leading cause of child morbidity and mortality. The aim of this study is to analyze the risk factors of ARI disease symptoms among children under the age of 5 years in Uganda.MethodsA cross-sectional design was used to analyze 2016 Uganda Demographic and Health Survey (UDHS) data collected on 13,493 children under the age of 5 years in Uganda. Various methods, such as logistic regression, elastic net logistic regression, decision tree, and random forest, were compared and used to predict 75% of the symptom outcomes of ARI disease. Well-performing methods were used to determine potential risk factors for ARI disease symptoms among children under the age of 5 years.ResultsIn Uganda, about 40.3% of children were reported to have ARI disease symptoms in the 2 weeks preceding the survey. Children under the age of 24 months were found to have a high prevalence of ARI disease symptoms. By considering 75% of the sample, the random forest was found to be a well-performing method (accuracy = 88.7%; AUC = 0.951) compared to the logistic regression method (accuracy = 62.0%; AUC = 0.638) and other methods in predicting childhood ARI symptoms. In addition, one-year old children (OR: 1.27; 95% CI: 1.12–1.44), children whose mothers were teenagers (OR: 1.28; 95% CI: 1.06–1.53), and farm workers (1.25; 95% CI: 1.11–1.42) were most likely to have ARI disease symptoms than other categories. Furthermore, children aged 48–59 months (OR: 0.69; 95% CI: 0.60–0.80), breastfed children (OR: 0.83; 95% CI: 0.76–0.92), usage of charcoal in cooking (OR: 0.77; 95% CI: 0.69–0.87), and the rainy season effect (OR: 0.66; 95% CI: 0.61–0.72) showed a low risk of developing ARI disease symptoms among children under the age of 5 years in Uganda.ConclusionPolicy-makers and health stakeholders should initiate target-oriented approaches to address the problem regarding poor children’s healthcare, improper environmental conditions, and childcare facilities. For the sake of early child care, the government should promote child breastfeeding and maternal education.

Prevalence and correlates of intimate partner violence among ever-married men in Uganda: a cross-sectional survey

BackgroundThere is limited research on intimate partner violence (IPV) among ever-married men in Uganda. This paper aimed to establish the extent and correlates of emotional, sexual, and physical IPV among ever-married men in Uganda.MethodsWe used the 2016 Uganda Demographic and Health Survey (UDHS) data and selected a weighted sample of 2559 ever-married men. Frequency distributions were used to describe the characteristics of men and their partners. Chi-square tests and binary logistic regressions were used to identify factors associated with IPV among married men in Uganda.ResultsAlmost half (44%) of the ever-married men experienced some form of IPV. Among the individual forms of IPV, emotional IPV was the most prevalent (36%), followed by physical IPV (20%) and sexual IPV the least common (8%). Factors that were associated with all the different forms of IPV included, region, number of wives, partners’ controlling behaviors, witnessing parental violence, and drinking alcohol as well as the frequency of getting drunk by the female partners. Except for number of wives, which had a protective effect, the rest of the factors increased the likelihood of experiencing intimate partner violence among ever-married men in Uganda.ConclusionsBesides women, men are also victims of intimate partner violence. This calls for combined efforts to reduce violence against men perpetrated by females by addressing controlling behaviors, frequency of getting drunk with alcohol, and lack of awareness of the issue. There is a need for interventions aimed at increasing public awareness to improve the reporting and case management of violence against men and boys.

Continuum of care for maternal health in Uganda: A national cross-sectional study.

A continuum of maternal care approach can reduce gaps and missed opportunities experienced by women and newborns. We determined the level of coverage and factors associated with the continuum of maternal care in Uganda. We used weighted data from the Uganda Demographic and Health Survey (UDHS) 2016. We included 10,152 women aged 15 to 49 years, who had had a live birth within five years preceding the survey. Stratified two-stage cluster sampling design was used to select participants. Continuum of maternal care was considered when a woman had at least four antenatal care (ANC) visits, had delivered in a health facility and they had at least one postnatal check-up within six weeks. We conducted multivariable logistic regression analysis to determine factors associated with completion of the continuum of maternal care using SPSS version 25. The level of coverage of complete continuum of maternal care was 10.7% (1,091) (95% CI: 10.0-11.2). About 59.9% (6,080) (95% CI: 59.0-60.8) had four or more antenatal visits while 76.6% (7,780) (95% CI: 75.8-77.5) delivered in a health facility and 22.5% (2,280) (95% CI: 21.5-23.2) attended at least one postnatal care visit within six weeks. The following factors were associated with continuum of maternal care; initiating ANC in the first trimester (AOR 1.49, 95% CI: 1.23-1.79), having secondary level of education (AOR 1.60, 95% CI: 1.15-2.22) and tertiary level of education (AOR 2.08 95% CI: 1.38-3.13) compared to no formal education, being resident in Central Uganda (AOR 1.44, 95% CI:1.11-1.89), Northern Uganda (AOR 1.35, 95% CI: 1.06-1.71) and Western Uganda (AOR 0.61, 95% CI: 0.45-0.82) compared to Eastern Uganda, and exposure to newspapers and magazines. The level of coverage of the complete continuum of maternal care was low and varied across regions. It was associated with easily modifiable factors such as early initiation of ANC, exposure to mass media and level of education. Interventions to improve utilisation of the continuum of maternal care should leverage mass media to promote services, especially among the least educated and the residents of Western Uganda.

Exposure to different types of mass media and timing of antenatal care initiation: insights from the 2016 Uganda Demographic and Health Survey

BackgroundEarly initiation of antenatal care (ANC) within the first trimester is highly recommended in the current 2016 World Health Organization (WHO) guidelines. Mass media has the potential to promote early initiation of ANC because it has been used successfully in several programs. However, there is paucity of literature on the effect of exposure to different types of media on the timing of ANC initiation in Uganda. Our study aimed at exploring associations between exposure to different types of mass media and timing of ANC initiation among women in Uganda.MethodsWe used a cross sectional study design, to conduct a secondary analysis of data collected in the 2016 Uganda Demographic and Health Survey (UDHS). We included weighted data of all the 10,152 women of reproductive age (15–49 years). Multistage stratified sampling was used to select study participants. Multivariable logistic regression was used to determine the association between exposure to different types of mass media and early initiation of ANC.ResultsAlmost a third of the women (2953/10,152, 29.1%, 95% CI 27.9–29.6) initiated their first ANC contact in the first trimester. Women who listened to radio at least once a week (adjusted OR (aOR 1.14, 95% CI 1.01–1.30) and those who watched television less than once a week (aOR 1.28, 95% CI 1.07–1.53) had higher odds of initiating ANC earlier compared to their counterparts not exposed to radio and television respectively.ConclusionExposure to radio and television is associated with timing of ANC initiation in Uganda. Importantly, the two types of mass media have the potential to reach women with low levels of education and encourage them to utilize maternal health services. The Ugandan government needs to prioritize and intensify the use of radio and television to promote the benefits associated with timing of ANC initiation.

Does disability increase households\u2019 health financial risk: evidence from the Uganda demographic and health survey

BackgroundIn the last few years, there has been a worldwide commitment to protect the vulnerable individuals from higher financial risk through out-of-pocket (OOP) health expenditure. This study examines the influence of disability and socio-demographic factors on households’ health financial risks in Uganda.MethodsWe used nationally representative cross-sectional data from the Uganda Demographic and Health Survey (UDHS) collected in 2016 by the Uganda Bureau of Statistics (UBOS) in Uganda. We measured financial risk (households’ health expenditure) by money paid for health care services. We estimated the “probit” model to investigate the effect of disability on health financial risk.ResultsA total of 19,305 households were included in this study. Almost 32% of households paid money for health care services access, among which 32% paid through out-of-pocket. Almost 41% of household heads were affected by disability. The majority (73%) of families went to the public sector for health care services. The mean age was 45 years (SD ± 15). We find that disability is significantly associated with the household financial risk (p < 0.01). The private sector’s choice for health care services is likely to positively affect the financial risk compared to the public sector (p < 0.01). The wealthier the household was, the more money paid for health service was (p < 0.01).ConclusionOur results indicated that disability and household socio-demographic characteristics were associated with health financial risk in Uganda. Identifying families with disability and experiencing difficult living conditions constitute an entry point for health authorities to enhance health coverage progress in low and middle-income countries.

Effect of four or more antenatal care visits on facility delivery and early postnatal care services utilization in Uganda: a propensity score matched analysis

IntroductionMaternal mortality remains a global public health issue, more predominantly in developing countries, and is associated with poor maternal health services utilization. Antenatal care (ANC) visits are positively associated with facility delivery and postnatal care (PNC) utilization. However, ANC in itself may not lead to such association but due to differences that exist among users (women). The purpose of this study, therefore, is to examine the effect of four or more ANC visits on facility delivery and early PNC and also the effect of facility-based delivery on early PNC using Propensity Score Matched Analysis (PSMA).MethodsThe present study utilized the 2016 Uganda Demographic and Health Survey (UDHS) dataset. Women aged 15 – 49 years who had given birth three years preceding the survey were considered for this study. Propensity score-matched analysis was used to analyze the effect of four or more ANC visits on facility delivery and early PNC and also the effect of facility-based delivery on early PNC.ResultsThe results revealed a significant and positive effect of four or more ANC visits on facility delivery [ATT (Average Treatment Effect of the Treated) = 0.118, 95% CI: 0.063 – 0.173] and early PNC [ATT = 0.099, 95% CI: 0.076 – 0.121]. It also found a positive and significant effect of facility-based delivery on early PNC [ATT = 0.518, 95% CI: 0.489 – 0.547].ConclusionPolicies geared towards the provision of four or more ANC visits are an effective intervention towards improved facility-based delivery and early PNC utilisation in Uganda.

Socio-economic and demographic factors associated with never having tested for HIV among sexually active men across the four administrative regions of Uganda

BackgroundHIV testing among men is paramount in the prevention, diagnosis, and treatment of HIV. There is limited literature in understanding the socio-economic and demographic factors associated with never having tested for HIV among sexually active men aged 15 – 54 across the four administrative regions of Uganda. The purpose of this study is to investigate the socio-economic and demographic factors associated with never having tested for HIV among sexually active men aged 15 – 54 across the four administrative regions in the country.MethodsThe study used a cross-sectional research design to examine factors associated with never having tested for HIV among 4,168 sexually active men (15 – 54 years) across four administrative regions of Uganda using data from 2016 Uganda Demographic and Health Survey (UDHS). Frequency distributions, Pearson chi-square tests, and multivariable logistic regression were used to establish the association between never having tested for HIV among sexually active men (15 – 54 years) and selected independent variables across regions.ResultsAbout 20% of sexually active men (15 – 54 years) never tested for HIV across regions of the country. The major correlates amidst variability of never testing for HIV among sexually active men across regions were; educational level and marital status. Age, religious status, wealth quintile, worked in the last 12 months, circumcised, and one sexual partner in the last 12 months were only correlates of never having tested for HIV among respondents in particular regions of the country.ConclusionFindings in the study suggest promotion of male education, and suggest further investigation into the relationship between HIV non-testing among sexually active men (15 – 54 years) and being married across regions of the country. The study also proposes appreciation of regional differences in the outcome of HIV non-testing and suggests that efforts be focused on addressing regional differences in order to attain high HIV testing among sexually active men (15 – 54 years) across regions of Uganda, and thus reduce HIV related morbidity and mortality.

Is cohabitation as a form of union formation a licence to intimate partner physical violence in Uganda?

The study examined the argument that cohabitation as a form of union increases physical violence victimization among women. The study's aim was to assess the association between physical violence and other socio-demographic factors that influence physical violence among women. Self-reported data were extracted from the 2016 Uganda Demographic and Health Survey (UDHS), with a sample of 2479 couples, from the couple file. Chi-squared tests and multivariate Firth-logit regression models were used to examine the relationship between intimate partner violence (IPV) victimization and marital status controlling for other social-demographic factors. There was no significant evidence that women in cohabiting union have a higher risk of exposure to physical violence in the Ugandan context. The risk of experiencing physical violence perpetration varied by birth cohort, with the most recent cohorts exhibiting a slightly higher risk of experiencing partner violence than previous cohorts. Significant factors found to be associated with an increased risk of experiencing IPV included being in the poorer, middle and richer compared with the poorest wealth tertile of income, residing in Eastern or Northern regions compared with the Central region, being affiliated to the Catholic faith compared with Anglican and having five or more children compared with 4 or fewer children. In conclusion, there is no evidence that physical violence is more pronounced among women in cohabiting unions compared with married women in Uganda.

Underweight and associated factors among lactating women in Uganda: Evidence from the Uganda demographic health survey 2016.

BackgroundLactating mothers are at increased risk of being underweight because of the physiological changes that lead to disproportionately higher energy and nutrient requirements compared to their non‐pregnant and non‐lactating counterparts.ObjectiveWe aimed to determine the prevalence and factors associated with being underweight among lactating women in Uganda.MethodsWe used the Uganda Demographic and Health Survey (UDHS) 2016 data of 1356 women aged 20 to 49 years. Multistage stratified sampling was used to select study participants. The data were collected using validated questionnaires. We used multivariable logistic regression to determine factors associated with underweight among 20 to 49‐year‐old lactating women in Uganda.ResultsThe prevalence of underweight was 8.2% (111/1356) (95% confidence interval, [CI]: 7.0‐10.0). Women who had no education were 10.21 (adjusted odds ratio, [AOR] = 10.21; 95% CI: 1.61‐64.74) times as likely to be underweight as those who had higher (post‐secondary) education levels. Women who were not working were 50% (AOR = 0.50; 95% CI: 0.26‐0.94) less likely to be underweight compared to those who were working. Women in the Western (AOR = 0.15; 95% CI: 0.07‐0.32), Eastern (AOR = 0.34; 95% CI: 0.18‐0.66), and Central (AOR = 0.30; 95% CI: 0.12‐0.74) regions were 85%, 66% and 70% respectively less likely to be underweight compared to those in the Northern region.ConclusionBased on the findings of this and other studies, it is important for the different stakeholders to design targeted nutrition programs for lactating women particularly those with low levels of education and those from the Northern region.

Factors associated with childhood overweight and obesity in Uganda: a national survey

BackgroundChildhood obesity is an emerging public health problem globally. Although previously a problem of high-income countries, overweight and obesity is on the rise in low- and middle-income countries. This paper explores the factors associated with childhood obesity and overweight in Uganda using data from the Uganda Demographic and Health Survey (UDHS) of 2016.MethodsWe used Uganda Demographic and Health Survey (UDHS) 2016 data of 4338 children less than 5 years. Multistage stratified sampling was used to select study participants and data were collected using validated questionnaires. Overweight and obesity were combined as the primary outcome. Children whose BMI z score was over two were considered as overweight while those with a BMI z score greater than three were considered as obese. We used multivariable logistic regression to determine factors associated with obesity and overweight among children under 5 years of age in Uganda.ResultsThe prevalence of overweight and obesity was 5.0% (217/4338) (95% CI: 4.3–5.6), with overweight at 3.9% (168/4338: 95% CI: 3.2–4.3) and obesity at 1.1% (49/4338: 95% CI: 0.8–1.5). Mother’s nutritional status, sex of the child, and child’s age were associated with childhood obesity and overweight. Boys were more likely to be overweight or obese (aOR = 1.81; 95% CI 1.24 to 2.64) compared to girls. Children who were younger (36 months and below) and those with mothers who were overweight or obese were more likely to have obesity or overweight compared to those aged 49–59 months and those with underweight mothers respectively. Children from the western region were more likely to be overweight or obese compared to those that were from the North.ConclusionThe present study showed male sex, older age of the children, nutritional status of the mothers and region of residence were associated with obesity and overweight among children under 5 years of age.

Prevalence and factors associated with sexual violence among women aged 15–49 years in rural Uganda: evidence from the Uganda Demographic and Health Survey 2016

ObjectivesSexual violence is a serious global health problem with short- and long-term physical, mental, and reproductive adverse effects. This study aimed to determine the prevalence and factors associated with sexual violence among women of reproductive age in rural Uganda. Study designThis was a cross-sectional study based on the Uganda Demographic and Health Survey (UDHS) 2016 data. MethodsUDHS 2016 data for 5259 rural women aged 15–49 years were used in this study. Multistage stratified sampling was used to select participants, and data were collected using validated questionnaires. Multivariable logistic regression was used to determine factors associated with sexual violence. All analyses we carried out in SPSS (version 25). ResultsThe overall prevalence of sexual violence among rural women was 24.3% (95% confidence interval [CI]: 23.4–25.7) compared with 18.4% (95% CI: 17.0–20.7) among urban women. Rural women who had received only primary education had higher odds of sexual violence compared with those who had received tertiary education (adjusted odds ratio [AOR] = 3.01, 95% CI: 1.17–7.72). Women living in the Western region were more likely to experience sexual violence than those living in the Northern region of Uganda (AOR = 2.01, 95% CI: 1.41–2.87). In addition, women in the poorest wealth quintile had higher odds of sexual violence compared with those in the richest quintile (AOR = 2.06, 95% CI: 1.02–4.17). Women justifying beating, health care decision-making, and husband's/partner's frequency of getting drunk were also significantly associated with sexual violence. ConclusionsThe prevalence of sexual violence among rural Ugandan women was high and is associated with factors such as educational level, region, wealth index, justified beating, health care decision-making, and husband's/partner's frequency of getting drunk. Thus, there is a need to improve the livelihoods and income of rural women, including the promotion of continued education for girls, as well as to strengthen protective laws and policies to curb this public health issue.

Prevalence and factors associated with modern contraceptives utilization among female adolescents in Uganda

BackgroundThe sexual and reproductive health (SRH) needs of adolescents remain largely unmet. For instance, over 20 million female adolescents in need of, a modern contraceptive method are not using any. This study determined the factors associated with utilization of modern contraceptives among female adolescents in Uganda.MethodsA cross sectional study was conducted using the Uganda Demographic and Health Survey (UDHS) 2016 data of 4, 264 adolescents aged 15 to 19 years. Multistage stratified sampling was used to select study participants. Multivariable logistic regression was used to determine the factors associated with modern contraceptive utilization. All our analyses were done using SPSS version 25.ResultsThe prevalence of modern contraceptive utilization among female adolescents was 9.4% (401/4264: (95% CI: 8.6–10.3). The odds of contraceptive utilisation were 1.6 times (AOR = 1.60; 95% CI: 1.09–2.34) higher among married adolescents compared to unmarried adolescents. Adolescents whose age at first birth was less than 15 years (AOR = 2.01; 95% CI: 1.01–3.99) were twice more likely to utilize a modern contraceptive compared to those whose age at first birth was above 15 years. Women belonging to the Central region (AOR = 1.93; 95% CI: 1.01–3.69) and those in the middle wealth quintile (AOR = 1.91; 95% CI: 1.06–3.46) were 93% and 91% more likely to utilize a modern contraceptive compared to those in the Northern region and those in the poorest wealth index respectively.ConclusionThe prevalence of modern contraceptive utilization was 9.4%. The findings show the need for designing targeted interventions due to differences in adolescents according to their wealth index, regions and marital status.