Uganda Health Research Articles

The need to improve antimicrobial susceptibility testing capacity in Ugandan health facilities: insights from a surveillance primer

BackgroundLab-based surveillance (LBS) of antimicrobial resistance (AMR) is not systematically implemented in Uganda. We aimed to identify the gaps in establishing regular LBS of AMR in Uganda.MethodsThis was a retrospective records review. It was done at Mulago Hospital (MH) Microbiology Lab (MHL). It analyzed lab records on bacteria and their antimicrobial susceptibility profiles (ASPs) over 6 months. Since MH is the national referral hospital, we hypothesized that (1) MHL is the best resourced and that any limitations seen here are amplified in labs at regional referral hospitals (RRHs) and health centers (HCs); (2) data from MHL on LBS mirrors that from labs at RRHs and HCs; (3) the state of records from MHL show lab performance and the presence or absence of standard operating procedures (SOPs), as would be the case at RRHs and HCs.ResultsThe lab got 1760 samples over the six months. The most common sample was urine (659, 37.4%). From the 1760 samples, data on 478 bacterial isolates were available. Urine gave the most isolates (159, 33.3%). Most of the isolates were gram-negative (267, 55.9%). Escherichia coli (100, 37%) was the most common gram-negative (of the Enterobacteriaceae). Pseudomonas aeruginosa (17, 6%) was the most common gram-negative (of the non-Enterobacteriaceae). The gram-negative bacteria were highly resistant to β-lactams. These were highly sensitive to carbapenems. The Staphylococcus aureus were highly resistant to β-lactams. The gram-positive bacteria were highly sensitive to vancomycin. ASPs for all bacterial categories were incomplete.ConclusionsThe findings from MHL suggest that there is a need to improve antimicrobial susceptibility testing capacity. They also suggest that the situation at RRHs and HCs around the country could be worse. So, there is a need to extend the political will, which already exists, into operational and implementation action.

‘Writing budgets for meetings and teas?’: a multitheoretical analysis of intragovernmental coordination for multisectoral action for health in Uganda

IntroductionCoordination across policy domains and among government agencies is considered critical for addressing complex challenges such as inequities, urbanisation and climate change. However, the factors influencing coordination among government entities...

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.

Testing efficiency in the health sector: a case of Uganda's health centre IVs

Testing efficiency in the health sector: a case of Uganda's health centre IVs

Factors Associated with the Timing and Number of Antenatal Care Visits among Unmarried Compared to Married Youth in Uganda between 2006 and 2016

Antenatal care is an important determinant of pregnancy and childbirth outcomes. Although the youth disproportionately experience adverse maternal complications and poor pregnancy outcomes, including maternal mortality, timely and frequent use of antenatal care services among unmarried youth in Uganda remains low. This study examines the factors that are important predictors of the use of antenatal health care services among unmarried and married youth. Binary logistic regression was conducted on the pooled data of the 2006, 2011 and 2016 Uganda Demographic and Health Surveys among youth who had given birth within five years before each survey to examine the predictors of ANC use. This analysis was among a sample of 764 unmarried, compared to 5176 married youth aged 15–24 years. Overall, married youth were more likely to have more frequent antenatal care visits (56% versus 53%) and start antenatal care early (27% versus 23%) than unmarried youth. Factors significantly associated with use of antenatal care in the first trimester were education and occupation among unmarried youth, and place of residence and access to the radio among married youth. Key predictors of ANC frequency among unmarried youth were parity, education level, pregnancy desire, age group, sex of head of household and region of residence. Among married youth, significant predictors of ANC frequency were parity, pregnancy desire, occupation, access to the radio and region of residence. These findings will help inform health-care programmers and policy makers in initiating appropriate policies and programs for ensuring optimal ANC use for all that could guarantee universal maternal health-care coverage to enable Uganda to achieve the SDG3.

Determinants of malaria testing at health facilities: the case of Uganda

BackgroundThe World Health Organization (WHO) recommends prompt malaria diagnosis with either microscopy or malaria rapid diagnostic tests (RDTs) and treatment with an effective anti-malarial, as key interventions to control malaria. However, in sub-Saharan Africa, malaria diagnosis is still often influenced by clinical symptoms, with patients and care providers often interpreting all fevers as malaria. The Ministry of Health in Uganda defines suspected malaria cases as those with a fever. A target of conducting testing for at least 75% of those suspected to have malaria was established by the National Malaria Reduction Strategic Plan 2014–2020.MethodsThis study investigated factors that affect malaria testing at health facilities in Uganda using data collected in March/April 2017 in a cross-sectional survey of health facilities from the 52 districts that are supported by the US President’s Malaria Initiative (PMI). The study assessed health facility capacity to provide quality malaria care and treatment. Data were collected from all 1085 public and private health facilities in the 52 districts. Factors assessed included supportive supervision, availability of malaria management guidelines, laboratory infrastructure, and training health workers in the use of malaria rapid diagnostic test (RDT). Survey data were matched with routinely collected health facility malaria data obtained from the district health information system Version-2 (DHIS2). Associations between testing at least 75% of suspect malaria cases with several factors were examined using multivariate logistic regression.ResultsKey malaria commodities were widely available; 92% and 85% of the health facilities reported availability of RDTs and artemether–lumefantrine, respectively. Overall, 933 (86%) of the facilities tested over 75% of patients suspected to have malaria. Predictors of meeting the testing target were: supervision in the last 6 months (OR: 1.72, 95% CI 1.04–2.85) and a health facility having at least one health worker trained in the use of RDTs (OR: 1.62, 95% CI 1.04–2.55).ConclusionThe study findings underscore the need for malaria control programmes to provide regular supportive supervision to health facilities and train health workers in the use of RDTs.

Determinants of prelacteal feeding practice in Uganda; a population based cross-sectional study using Uganda demographic and health survey data.

Breastfeeding has well-established short-term and long-term health benefits for both the mother and infant. Initiating breastfeeding immediately after birth stimulates breast milk production. Prelacteal feeding (PLF) may result in late initiation of breastfeeding, and thus insufficient production of breast milk. This study aimed to identify the determinants of PLF among children under five years in Uganda. This cross-sectional study was conducted using the data from the database of Uganda Demographic and Health Survey 2011. The data of 4,774 children/mothers were evaluated in this study. The prevalence of PLF was 40.3%. The rate of PLF practice was found to be 2.15 times higher in women with moderate economic status and 2.02 times higher in women with high economic status compared to those who have low economic status. The rate of PLF practice was found to be 1.73 times higher in newborns delivered by an unskilled birth attendant and 4.35 times higher in newborns delivered with no birth attendant compared to those infants delivered by a skilled birth attendant. The ratio of PLF practice was found to be 2.49 times higher in multiple births. Mothers who initiated breastfeeding in the first 24 hours after birth had higher odds of PLF. No relationship was found between PLF practice with some sociodemographic characteristics of mother's (age, marital status, educational status, religion, residential location), maternal factors (number of children, antenatal and postnatal care attendance, place of delivery), and characteristics of the newborn infants (sex, type of delivery, birth order number) in the multivariate logistic regression analysis. All mothers should be informed about the importance of initiation of breastfeeding immediately after delivery, the risks associated with PLF, the optimal practices for breastfeeding, and the presence of a skilled birth attendant at delivery.

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.

Lower Back Pain as an Occupational Hazard Among Ugandan Health Workers.

Background: Lower back pain is a public health concern affecting 70–85% of the world's population. There is paucity of published data on the prevalence, disability and risk factors for lower back pain among health workers in Uganda.Objective: To determine the frequency rate (note that is it implicit that frequency is a rate like incidence so including rate seems redundant here. This is bounded by zero and infinity. In contrast, prevalence is bounded by 0 and 1 and is thus a proportion not a rate) of lower back pain and its associated risks amongst health professionals in the Arua District of Uganda.Methods: Cross-sectional descriptive study of 245 consecutive participants conducted during February-April 2020. We stratified risks as individual or work related and analyzed the data using IBM SPSS version 25. Chi-square was used to measure the significance of association between categorical variables at 95% confidence interval, regarding a p ≤ 0.05 as significant.Results: The mean age of participants was 40.87 years ± 8.74 (SD), with female predominance (69.8%). Majority were either general nurses or midwives (64.9%) and more than half had practiced for over 6–10 years. The frequency rate of lower back pain was 39.6% (n = 97). Individual factors associated with LBP were; cigarette smoking (X2 = 33.040; P ≤ 0.001), alcohol consumption (X2 = 13.581; P ≤ 0.001), age (X2 = 14.717; P = 0.002), and female gender (X2 = 4.802; P = 0.028). The work related factors significantly associated with lower back pain were: being a nurse/midwife (X2 = 9.829; P = 0.007), working in the outpatient department (X2 = 49.752; P ≤ 0.001), bending (X2 = 43.912; P ≤ 0.001), lifting (X2 = 33.279; P < 0.001), over standing (X2 = 40.096; P ≤ 0.001), being in awkward positions (X2 = 15.607; P= < 0.001), and pushing patients (X2 = 21.999; P ≤ 0.001).Conclusion: The frequency rate of low back pain was high amongst health workers and its main associated individual and work related factors could have been prevented. Health workers should strike a balance between caring for their personal back-health and meeting clients' needs while manually handling patients. Ergonomic structuring, job organization, back health care courses and use of assistive equipment could reduce such occupational hazards in our low resourced settings.

Mental Health in Uganda and Canada: A Descriptive Case Study of the Issue and Recommendations for Improved Mental Health

Mental health is a crucial part of overall wellbeing. Canada’s mental health system has progressed over the last decade but still has room for improvement. In comparison, developing countries, such as Uganda, have not shown the same progression with their mental health systems. The embedded experience, together with expert consultations in the field, was conducted over several months at a human immunodeficiency virus (HIV) specialized hospital, the Joint Clinical Research Center (JCRC) in Kampala, Uganda on the topic of mental health systems. The observations and consultations were thematically analyzed into four main themes: cultural attitudes towards mental illness, the interconnectedness of childhood HIV and mental health, a gap in education for mental health professionals to become certified, and barriers to addressment of mental health issues at the JCRC. The main barriers for Ugandans seeking professional treatment were also identified, which included the accessibility and availability of professional treatment. Local solutions are outlined, as well as recommendations for improvements and future research.

Provision of adolescent health care in Resource-Limited Settings: Perceptions, practices and training needs of Ugandan health care workers

Adolescent health is increasingly recognized as a global priority. However, gaps exist in training in adolescent health for frontline health care workers (HCWs) in low- and middle-income countries (LMICs). This mixed methods study utilized data from focus groups and quantitative surveys to better understand the perceptions, practices, and training needs of HCWs who provide care to adolescents in eastern Uganda. Focus group discussions (FGD) were conducted with thirty-six HCWs, who demonstrated a nuanced understanding of the specific health care needs of adolescents, citing HIV care and HPV vaccination as priorities, and indicating comfort in the provision of these services. Quantitative results indicated less comfort with contraception and safe sex counseling, as well as treating mental health and addiction problems. In focus groups, HCWs were divided as to whether or not unmarried adolescents should be able to access essential components of reproductive healthcare, including contraception and non-HIV testing for sexually transmitting infections (STIs). Most agreed that HIV testing and treatment should be offered to all adolescents. HCWs also acknowledged the challenges of delivering culturally appropriate care amidst societal stigma regarding sexual health. Additional challenges in adolescent care include limited resources, lack of standard practices for providing confidential care, and limited training in adolescent development. There is a need for further discussion and training among HCWs to increase their comfort level in providing care for adolescents, and the majority of participants in this study (96%) were interested in obtaining this additional training.

A 10-hours workshop improves physical activity prescription for mental illness knowledge and confidence in health care professionals: a nation-wide multicentre study from Uganda

Purpose Lack of knowledge about and confidence in physical activity (PA) prescription for people with mental illness are important barriers for clinical practice in low-income countries. The aim of this study was to evaluate whether a 10-hour workshop improved the knowledge and confidence in PA prescription among health care professionals in 13 regional referral hospitals across Uganda. Material and methods 260 health care professionals (age = 40.4 ± 10.8 years; 48% women; 63.8% nurses, 10% social workers, 8.1% psychologists, 7.3% medical doctors, 5.8% psychiatrists, 5% physical or occupational therapists) completed the Exercise in Mental Illness Questionnaire – Health Professionals Version (EMIQ-HP) pre- and post-workshop. Results The EMIQ-HP PA knowledge score (3.1 ± 0.7 versus 1.3 ± 1.3, p < 0.001, Cohen’s d = 1.28, 95% confidence interval, CI = 1.04–1.52, i.e., large effect) and EMIQ-HP confidence in PA prescription score (3.0 ± 0.8 versus 1.2 ± 1.2, p < 0.001, Cohen’s d = 1.14, 95% CI = 0.91–1.36, i.e., large effect) improved significantly following training. Significantly more benefits and fewer barriers to prescribing PA in busy low-resourced settings were reported. Conclusions Training in PA counselling improved the knowledge and confidence in PA prescription in Ugandan health care professionals. Future research should investigate whether PA uptake in people with mental illness can be improved via additional training of health care professionals. IMPLICATIONS FOR REHABILITATION The majority of mental health professionals never recommend physical activity to their patients in low-resourced settings and increased awareness is needed to improve rehabilitation programs. Training in prescribing physical activity using the 5A framework improves knowledge about physical activity prescription in mental health professionals at all levels of care. Training in prescribing physical activity using motivational interviewing improves confidence in physical activity prescription in rehabilitation programs. Training in prescribing physical activity reduces perceived barriers for prescribing in rehabilitation programs in low-resourced settings.

Global Discourses and Local Disconnects: Gender, Aging, Health, and Well-Being in Uganda

Women comprise a larger share of the world’s aging population. Because older women occupy two stigmatized statuses, they are deemed a particularly disadvantaged group requiring attention. International organizations claim that the feminization of population aging has the potential to become one of the biggest challenges to gender equality of the twenty-first century due to cumulative impacts of inequalities in later life. Yet, discussions uncritically assume that older women are a permanent minority, ignoring the possibility that the direction of gender inequality or its absence varies. This article engages with these contradictions by examining links between gender, aging, and inequalities. Drawing on human geography perspectives of gender, embodiment, and temporalities, interviews with elderly men and women (n = 53) and key informants (n = 34) in Uganda demonstrate that old age health and well-being is an amalgamation of gendered experiences and social dynamics (re)produced and (re)articulated across the life course. Illuminating how gender inequalities are embodied through diverse spatial and temporal relations exposes a counternarrative to global discourses, revealing that gender and aging are experienced and navigated in sometimes unexpected and contradictory ways. Putting forth a feminist political ecology life course perspective highlights needed geographic attention to antecedent place processes that relationally co-constitute gender – age inequalities.

Utilization of HIV testing and counselling services by women with disabilities during antenatal care in Uganda: analysis of 2016 demographic and health survey

BackgroundHIV testing and counselling during antenatal care (ANC) is critical for eliminating mother-to-child transmission of HIV. We investigated disparity in utilization of HIV testing and counselling services (HTC) between women with and without disabilities in Uganda.MethodsWe conducted a retrospective study using the nationally representative 2016 Uganda Demographic and Health Survey. The study sampled 10,073 women between age 15–49 who had a live birth in the last 5 years. We estimated unadjusted and adjusted odds ratio for receiving pre-test HIV counselling, obtaining an HIV test result, and post-test HIV counselling by disability status using logistic regressions.ResultsWe found that women with disabilities were less likely to receive pre-test HIV counselling (59.6 vs 52.4), obtain an HIV test result (68.2 vs 61.4), receive post-test HIV counselling (55.5 vs 51.6), and all HTC services (49.2 vs 43.5). From the regression analysis, women with disabilities were less likely to receive pre-test counselling [AOR = 0.83; CI = 0.74, 0.93] and obtain an HIV test result [AOR = 0.88; CI = 0.78, 0.99].ConclusionsOur findings revealed that women with disabilities are less likely to receive HTC service during ANC and highlighted the need for disability-inclusive HIV and reproductive health services. Government, non-governmental organizations, and other stakeholders should consider funding inclusive campaigns and identifying other mechanisms for disseminating health information and behavioral interventions to women with disabilities.

Determinants of change in the inequality and associated predictors of teenage pregnancy in Uganda for the period 2006–2016: analysis of the Uganda Demographic and Health Surveys

ObjectiveTeenage pregnancy has become a public health concern in Uganda because of its negative consequences to both the mother and child. The objective of this study was to examine the...

Factors associated with health facility utilization during childbirth among 15 to 49-year-old women in Uganda: evidence from the Uganda demographic health survey 2016

BackgroundAlmost all maternal deaths and related morbidities occur in low-income countries. Childbirth supervised by a skilled provider in a health facility is a key intervention to prevent maternal and perinatal morbidity and mortality. Our study aimed to establish the factors associated with health facility utilization during childbirth in Uganda.MethodsWe used the Uganda Demographic and Health Survey 2016 data of 10,152 women aged 15 to 49 years. The study focused on their most recent live birth in 5 years preceding the survey. We applied multistage stratified sampling to select study participants and we conducted multivariable logistic regression to establish the factors associated with health facility utilization during childbirth, using SPSS (version 25).ResultsThe proportion of women who gave birth at a health facility was 76.6% (7780/10,152: (95% confidence interval, CI, 75.8–77.5). The odds of women aged 15–19 years giving birth at health facilities were twice as those of women aged 40 to 49 years (adjusted odds ratio, AOR = 2.29; 95% CI: 1.71–3.07). Residing in urban areas and attending antenatal care (ANC) were associated with health facility use. The odds of women in the northern region of Uganda using health facilities were three times of those of women in the central region (AOR = 3.13; 95% CI: 2.15–4.56). Women with tertiary education (AOR = 4.96; 95% CI: 2.71–9.11) and those in the richest wealth quintile (AOR = 4.55; 95% CI: 3.27–6.32) had higher odds of using a health facility during child birth as compared to those with no education and those in the poorest wealth quintile, respectively. Muslims, Baganda, women exposed to mass media and having no problem with distance to health facility had higher odds of utilizing health facilities during childbirth as compared to Catholic, non Baganda, women not exposed to mass media and those having challenges with distance to access healthcare.ConclusionHealth facility utilization during childbirth was high and it was associated with decreasing age, increasing level of education and wealth index, urban residence, Northern region of Uganda, ANC attendance, exposure to mass media, tribe, religion and distance to the nearby health facility. We recommend that interventions to promote health facility childbirths in Uganda target the poor, less educated, and older women especially those residing in rural areas with less exposure to mass media.

COVID-19 information dissemination in Uganda: Perspectives from sub-national health workers

BackgroundIn many places, health workers at the sub-national level are on the frontlines of disseminating information about coronavirus (COVID-19) to communities. To ensure communities are receiving timely and accurate information, it is vital health workers are kept abreast of the most recent recommendations, and guidance.MethodsAn electronic survey was implemented to provide insights about the dissemination and utilisation of information and evidence related to the COVID-19 pandemic by health workers engaged at sub-national levels of the Ugandan health system. The aim of this survey was to provide insights about the dissemination and utilisation of information and evidence related to the coronavirus (COVID-19) pandemic by individuals engaged at sub-national levels of the health system.ResultsMass media and public health campaigns and outreach activities were deemed the most suitable means to reach communities with COVID-19 information. Given the reported disruption to public outreach campaigns, this is a particularly important consideration for the provision of information to communities. All materials should be adapted to the local context. The need for information on homecare of COVID-19 patients was highlighted, along with the need for updated local statistics as to COVID-19 cases to be relayed for health workers at sub-national levels.ConclusionsUnderstanding the sources of information used by health workers can facilitate the transfer of relevant and timely information, which in turn increases the use of such information by the Ugandan population. It is vital that these issues are continued to be monitored, and communication modes and content are actively responsive to the time- and place-specific needs of health workers and community members.

Factors Associated with Land Ownership by Women in Uganda: A Cross-Sectional Study

Aims: There is growing evidence concerning the significance of asset ownership by women. However, in Sub-Saharan Africa, asset ownership is lower for women compared to men. This study investigated factors associated with land ownership by women in Uganda.&#x0D; Study Design: Cross-sectional study.&#x0D; Place and Duration of Study: The Uganda Demographic and Health Survey 2016 data was collected by the Uganda Bureau of Statistics from 20 June to 16 December 2016. &#x0D; Methodology: The logistic regression model was fitted to determine factors significantly associated with land ownership.&#x0D; Results: The likelihood of a woman owning land increased with an increase in her age and reduced with improvement in her household's wealth index. Furthermore, the likelihood of owning land was lowest for women; aged 18-19 years, residing in the Central region, residing in urban areas, of single status, with no account in a bank or other financial institution, in the richest wealth index category, and those currently not working.&#x0D; Conclusion: There is a need to develop more effective strategies to empower women regarding land ownership and control. There is a need to sensitize women about their rights to land ownership, about saving with registered financial institutions which increases their likelihood of accessing alternative funding sources to support their purchase of land and other valuable assets.