Department of Public Health

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https://bdears.busitema.ac.ug/handle/123456789/349

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Browsing Department of Public Health by Author "Agaba, Brian"

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    Exploring barriers and facilitators of preceptorship in undergraduate health professions education : insights from a qualitative needs assessment among preceptors in Eastern Uganda.
    (BMC, 2025) Wani, Solomon; Nantale, Ritah; Atuhairwe, Irene; Makoko, Brian Tonny; Okello, Francis; Waako, Paul; Twineamatsiko, Andrew; Agaba, Brian; Nyalihama, Alain; Kibuule, Dan; Kagoya, Enid Kawala
    Background: Clinical preceptorship plays a critical role in bridging theoretical knowledge and practical skills for health professions students. In resource-constrained settings like Eastern Uganda, understanding what facilitates effective preceptorship is essential for improving clinical education outcomes. This study explores the barriers and facilitators to preceptorship among clinical preceptors and faculty at Busitema University, Mbale College of Health Sciences, and Mbale Regional Referral Hospital. Methods: We conducted 15 in-depth interviews with clinical preceptors, including faculty and clinical staff from Busitema University, Mbale College of Health Sciences, and Mbale Regional Referral Hospital. Participants were purposively selected based on experience, education level, medical care, and leadership roles. We conducted the interviews between May 2024 and June 2024, audio-recorded, were transcribed verbatim, and thematically analyzed using Atlas.ti version 9. Results: Three key facilitators and six barriers to preceptorship emerged from the analysis. The facilitators included: support from Seed Global Health through donations of medical tools, equipment, and healthcare worker training; strong commitment and willingness among health workers at Mbale Regional Referral Hospital to teach students; and, support from faculty and postgraduate students at Busitema University. Barriers were: high numbers of students in clinical settings; poor communication and coordination between academic institutions and clinical sites; limited preceptorship skills and knowledge among clinical preceptors; shortages of faculty preceptors; insufficient time for clinical rotations; and inadequate models and equipment for simulation-based teaching. To address these challenges, preceptors recommended better coordination and student orientation, phased placement in smaller groups, training and refresher courses to strengthen preceptorship capacity, increased faculty presence in wards, and provision of essential medical equipment. Conclusion: Effective preceptorship in resource-limited settings depends on leveraging facilitators while addressing persistent barriers. External partnerships, staff commitment, and faculty support are valuable enablers, but their impact is undermined by overcrowding, poor coordination, and resource shortages. Actionable strategies such as structured communication between training institutions and hospitals, phased student placement, targeted preceptor training, and investments in teaching equipment can mitigate barriers and reinforce facilitators. Strengthening these systems is vital for sustaining high-quality clinical education in Uganda and similar contexts. Keywords: Preceptorship, Barriers, Facilitators, Medical education, Uganda
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    Watching over life : practices and meanings of postpartum vital signs monitoring in eastern Uganda.
    (medRxiv, 2025) Babuya, Jonathan; Kayemba, Frank; Waiswa, Sinani; Nsubuga, Allan G.; Ewing, Helen; Atuhairwe, Irene; Ijangolet, Esther; Otim, Eric; Ronald, Kibuuka; Jesca, Atugonza; Okello, Francis; Nakattudde, Prossy; Nyangoma, Faith; Nakawuka, Betty; Kabahinda, Nichola; Kamwesigye, Assen; Apoya, Jill; Waako, Paul; Wandabwa, Julius; Musaba, Milton; Bonaventure, Ahaisibwe; Aeby, Tod; Nandutu, Sarah; Mugabe, Kenneth; Pangholi, Kennedy; Nahurira, Doreck; Agaba, Brian; Mbwali, Immaculate; Bahati, Johnson; Kagoya, Enid Kawala
    Introduction Postnatal deaths account for about one-third of maternal mortality in Low- and middle-income countries (LMICs). Nearly half occur within the first 24 hours and are preventable through continuous inpatient monitoring. This study assessed maternal mortality within the first 24 postnatal hours; and the current postpartum monitoring practices, including the availability of monitoring charts and the frequency of vital sign assessments in eastern Uganda. Methods This cross-sectional study reviewed the medical records of all postpartum women admitted at Mbale Regional Referral Hospital, Eastern Uganda, between August 2022 and February 2023. A semi-structured data extraction form was used. The outcome variable was postpartum monitoring; categorized as "No" for women with no vital signs monitored and "Yes" for those with at least one vital sign monitored. Descriptive analysis was performed using Stata Version 17.0, and Poisson regression was employed to explore the association between various factors and postpartum monitoring. Results Medical records of 2,717 postpartum mothers were reviewed. The median (interquartile range) age was 25(20-30) years. A minority (34%; 910/2717) of mothers had vital sign observation charts in their medical records and very few (4%; 110/2717) had a fluid balance chart. About 49 24% (651/2717) of mothers had at least one vital sign recorded. Blood pressure was the most (16.8%; 456/2717) recorded vital sign followed by pulse rate (13.6%; 369/2717). Respiratory rate and temperature were the least monitored vital signs with 1.2% and 1.1% records respectively. Mothers who delivered by C-section had a 151% higher prevalence of postpartum monitoring compared to those who had a vaginal delivery (aPR: 2.51; 95% CI: 2.19–2.89). Maternal mortality rate on the first postpartum day was 8.8 per 1000, with postpartum hemorrhage accounting for 61%. Conclusion Postpartum vital signs monitoring was low. LMICs need to devise means of automating the monitoring process.