Browsing by Author "Okalany, Regina Akwi Noela"

Now showing 1 - 2 of 2
  • No Thumbnail Available
    Item
    Acceptability of minimal invasive tissue sampling (MITS) for stillbirths in Eastern Uganda
    (PLOS One, 2025) Chebet, Martin; Burgoine, Kathy; Rujumba, Joseph; Okalany, Regina Akwi Noela; Olupot-Olupot, Peter; Tylleskär, Thorkild; Weeks, D. Andrew; Napyo, Agnes; Mukunya, David; Engebretsen, Marie S. Ingunn
    Background In sub-Saharan Africa, stillbirth rates remain high. To design effective interventions to reduce stillbirths, accurate determination of their aetiology is important. Conventional autopsy for accurate confirmation of cause is not acceptable or feasible in several societies in sub-Saharan Africa; minimal invasive tissue sampling (MITS), is a recently developed, less invasive alternative. In this study, we explored the acceptability of MITS in the community and among healthcare workers in Uganda to guide the future implementation. Methods A qualitative study was done among community members and healthcare workers in Mbale in Eastern Uganda. We undertook in-depth interviews and focus group discussions in English or local languages. Interviews were audio-recorded, transcribed as necessary prior to formal content analysis. The themes were organised using NVivo software and presented according to Sekhon’s theoretical framework. Results Overall, participants preferred the idea of MITS to conventional autopsy because of the perception that it was fast, maintained the facial appearance and kept the body intact. It was thought that the procedure would improve the detection of the cause of stillbirths, which in turn would help to prevent future stillbirths. It would also resolve conflicts in the community between community members or the women and the healthcare workers about the cause of a stillbirth. It was suggested that some community members may not approve of MITS because of their religious beliefs; the fear that the body parts may be extracted and stolen for witchcraft or organ donation; and a lack of trust in the healthcare system. To implement the procedure, it was suggested that extensive community sensitization should be done, space limitations in healthcare facilities overcome, healthcare workers should be trained and limited human resource should be addressed. Conclusion The implementation of MITS in Mbale, Eastern Uganda, is likely to be acceptable given sufficient training and sensitisation.
  • No Thumbnail Available
    Item
    Term stillbirths in Eastern Uganda: a community-based prospective cohort study
    (Taylor & Francis Group, 2025) Chebet, Martin; Olupot-Olupot, Peter; Weeks, D Andrew; Engebretsen, Marie S Ingunn; Okalany, Regina Akwi Noela; Okello, Francis; Tylleskär, Thorkild; Burgoine, Kathy; Mukunya, David
    Background: Every year, 1.9 million stillbirths occur worldwide, of whom 1.5 million occur in sub-Saharan Africa (SSA) and Southeast Asia. Objectives: This study aims to determine the incidence and risk factors and to describe underlying causes for term stillbirths in Eastern Uganda. Methods: This was a cohort study of pregnant women enrolled at 34 weeks of gestation or more and followed to birth between January 2021 and January 2024. Enrolment and follow-up were done in the community by trained midwives. Using structured questionnaires, details of maternal health, pregnancy and birth were captured. Results: We enrolled 6101 participants and analysed 5496 for incidence of term stillbirth and 5296 for risk factors. Of the participants, 4913/5296 (92.8%) were between 14 and 35 years, and 4456/5296 (84.1%) had a health facility birth. There were 101 term stillbirths (61 were intrapartum and 40 antepartum). The incidence of term stillbirth was 18.4 per 1000 births (95% CI 14.8 to 22.9). The most common underlying causes of stillbirth were prolonged or obstructed labour 32/101 (31.7%) and malaria 20/101 (19.8%). The factors associated with term stillbirths were caesarean birth (aRR 3.3; 95% CI 2.00 to 5.4), intimate partner violence (aRR 1.8; 95% CI 1.1 to 2.8) and maternal age above 35 years (aRR 2.2; 95% CI 1.2 to 3.9). Conclusion: Eastern Uganda has a high rate of term stillbirths with more than half occurring during labour. Efforts are needed to improve the quality of birth care and to prevent intimate partner violence.