Browsing by Author "Nsubuga, Allan G."

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    Catching babies, carrying traditions : the voices and practices of traditional birth attendants in Mayuge District, East central Uganda.
    (BMC, 2025) Kagoya, Enid Kawala; Auma, Proscovia; Mugabi, Joshua; Kawala, Elizabeth; Asabawebwa, Deogratias; Mugahi, Richard; Mutunda, Brenda Doreen; Gamubaka, Richard; Namaganda, Agnes; Nsubuga, Allan G.; Akello, Jackline; Waako, Paul; Mugabe, Kenneth
    Background: Traditional Birth Attendants (TBAs) continue to support maternal and newborn care in rural Uganda, particularly where access to formal health facilities is limited. Their roles are deeply embedded in local culture and community trust, yet national policies provide inconsistent guidance on their engagement within the formal health system. Objective: To explore the evolution, experiences, practices, challenges, and perceived support needs of TBAs in Mayuge District, and examine their interaction with formal health structures. Methods: A qualitative narrative study was conducted with 15 purposively selected TBAs from all sub-counties of Mayuge District. In-depth interviews lasting 60 to 90 min were held at participants’ homes or workplaces. Participants described and demonstrated their maternal care practices. Audio recordings were transcribed, translated, and analyzed thematically. Results: Seven key themes emerged from the study: (1) Historical Developments and Evolution of TBAs, highlighting diverse pathways into practice such as apprenticeship, family mentorship, formal Ministry of Health training, and community programs; (2) Practices, Methods, and Approaches, detailing TBAs’ provision of antenatal, delivery, and postnatal care, and management of maternal and newborn complications using both traditional and modern methods including newborn resuscitation; (3) Infection Prevention and Control, revealing variable use of personal protective equipment and inconsistent waste disposal practices constrained by limited resources; (4) Maternal and Perinatal Death Surveillance and Response (MPDSR) Process, illustrating TBAs’ limited participation in formal death notifications and reviews; (5) Referral Process, highlighting complex referral behaviors involving health facilities, fellow TBAs, and traditional healers; (6) Socio-Cultural Influences on TBA Services, encompassing the impact of poverty, gender roles, community trust, and cultural norms; and (7) Challenges in Providing Safe and Effective Care, including barriers such as negative attitudes from health workers, transport difficulties, competition, and lack of formal support. Conclusion: TBAs in Mayuge District play a vital role in culturally grounded maternal care but face numerous challenges due to limited formal integration and support. Strategies are needed to strengthen collaboration, provide targeted training, and clarify policy to improve maternal and newborn health outcomes in underserved areas. Keywords: Traditional birth attendants, Maternal and newborn health, Socio-cultural determinants, Referral practices, Health system integration, Rural uganda
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    Community perspectives regarding preparedness, response and prevention of ebola virus disease amidst COVID-19 pandemic, an exploratory descriptive qualitative study using a community engagement approach in Mbale City.
    (Research Square, 2024) Kagoya, Enid Kawala; Nsubuga, Allan G.; Ewing, Helen; Atuhairwe, Irene; Ijangolet, Esther; Otim, Eric; Ronald, Kibuuka; Jesca, Atugonza; Okello, Francis; Nakattudde, Prossy; Nyangoma, Faith; Namara, Racheal; Nakabaale, Mark; Nakawuka, Betty; Nakawuki, Ashley; Kizito, Prisca; Waako, Paul; Wandabwa, Julius; Makoko, Tonny Brian; Musaba, Milton; Ahaisibwe, Bonaventure; Barugahare, Banson
    Background: Ebola virus disease (EVD) is a rare and deadly infectious hemorrhagic fever disease. Four of the 6 known Ebola virus species can cause human disease. Since 1976, EVD outbreaks have been recorded sporadically in East, Central, and West Africa. Uganda has experienced 6 documented outbreaks of EVD since 2000 that can be attributed to 3 species of Ebola viruses (Zaire, Sudan, and Bundibugyo). Despite substantial advances in clinical management, the case fatality ratio for EVD remains high, reaching more than 60% for the Zaire Ebola virus in 2018–2020. Methods. The study followed a descriptive qualitative study design. Data were collected using an interviewer-administered questionnaire with both closed and open-ended questions. Data were analysed using ATLAS Pro. Results: Our results illustrate the lack of health education in the community among the different categories of people and this comes from an emic perspective. We identified 4 high-level themes and 19 subthemes, (1) Knowledge of Ebola Virus Disease, (2) Prevention of EVD in the community, (3) Preparedness for Ebola Virus Disease, and (4) Community response to Ebola Virus Disease and the final thematic area (4) which included giving first aid, using traditional medicines, and approaching a health facility among others. Conclusions: With all the available information about the previous outbreaks in Uganda, it is surprising that less effort was made this time round to take local sensibilities and culture into account among other social factors contributing to the poor practices of masses toward the EVD, preparedness, prevention, and response. Keywords: Ebola Virus Disease, Preparedness, Response and Prevention, Community Engagement
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    Coping mechanisms for students with mental disorders : an exploratory qualitative study at Busitema University’s Mbale and Busia campuses.
    (PLOS One, 2025) Kagoya, Enid Kawala; Mpagi, Joseph; Waako, Paul; Muhwezi, Martha R. L.; Namaganda, Agnes; Nsubuga, Allan G.; Atala, Christine Etoko; Okello, Francis; Okibure, Ambrose; Kibuuka, Ronald; Wandera, Ernest; Ndamanywa, Kalisiti; Kirabira, Joseph
    In recent years, Ugandan universities have faced a rising incidence of mental health issues among students, with prevalence rates of mental disorders reaching up to 60% among undergraduates. These challenges significantly impact both academic performance and social interactions. This study aimed to investigate the coping mechanisms among students with mental disorders at Busitema University. We conducted 42 key informant interviews with students diagnosed with mental disorders, as determined by the Mini International Neuropsychiatric Interview. Interviews were guided by a structured protocol developed by the research team, and all participants provided informed consent. The interviews were audiotaped, transcribed verbatim, and analyzed using thematic analysis. This approach was chosen for its efficiency and directness. Nvivo software facilitated the coding and organization of themes. The study identified several coping strategies used by students at the two Busitema University campuses. Five main themes emerged: Alcohol and Substance Use, Use of Sedatives, Social and Personal Initiatives, Seeking Counseling Services, Withdrawal and Confrontation, and Faith Healing. Various subthemes were also noted, including substance use, withdrawal, confrontations, witchcraft, participation in co-curricular activities, abortions, and seeking psychosocial support. These findings are detailed in Table 2. Addressing the mental health challenges faced by university students requires a thorough understanding of their coping strategies. While some strategies are self-developed, others involve university-led interventions. It is crucial to reinforce effective coping mechanisms and address detrimental ones to improve students’ mental health outcomes. Mental disorders, coping strategies, university students, 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.