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Article ; Online: Unlocking the power of communities to achieve Universal Health Coverage in Africa

Rawlance Ndejjo / Geofrey Musinguzi / David Musoke / Rhoda K. Wanyenze

South Eastern European Journal of Public Health (2021)

2021

Abstract: Africa is at a critical time undergoing demographic, epidemiological, political and socio-economic transitions and faced with repeated outbreaks of emerging and remerging diseases amidst other broader challenges of climate change, environmental ... ...

Abstract	Africa is at a critical time undergoing demographic, epidemiological, political and socio-economic transitions and faced with repeated outbreaks of emerging and remerging diseases amidst other broader challenges of climate change, environmental degradation and pollution testing the resilience of its health systems and hindering progress to achieve health for all. Five years into the journey towards Sustainable Development Goals (SDGs), the continent – similar to the rest of the world – has been gripped with the Corona virus disease pandemic that has caused significant morbidity and mortality as well as severely disrupted health systems and the underlying socioeconomic determinants of health. One of the most significant SDG targets is the achievement of Universal Health Coverage (UHC) where all people have access to quality health services they need without inflicting a financial hardship on them. However, progress towards this target has been slow on the continent and requires rethinking the current approaches employed. We argue that Africa’s key strength lies in the communities whose potential should be unlocked to build cost effective and sustainable bottom-up health systems founded on Primary Health Care (PHC). Such systems should be founded on community-based services, designed around individuals, families and the community involving community health workers and other actors, and capitalising on health promotion and disease prevention approaches. A strong community health system should be adequately linked to district, regional and national levels working together to empower and serve populations to make health for all a reality.
Keywords	community health ; disease prevention ; health for all ; health promotion ; primary health care ; Public aspects of medicine ; RA1-1270
Subject code	360
Language	English
Publishing date	2021-04-01T00:00:00Z
Publisher	Jacobs Verlag
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Understanding factors influencing uptake of healthy lifestyle practices among adults following a community cardiovascular disease prevention programme in Mukono and Buikwe districts in Uganda

Rawlance Ndejjo / Geofrey Musinguzi / Fred Nuwaha / Hilde Bastiaens / Rhoda K. Wanyenze

PLoS ONE, Vol 17, Iss

A qualitative study

2022 Volume 2

Abstract: Introduction Healthy lifestyle practices including physical activity, healthy diets, non-smoking, reduced alcohol consumption and stress reduction are important in the prevention of metabollic CVD risk factors such as hypertension, overweight and obesity, ...

Abstract	Introduction Healthy lifestyle practices including physical activity, healthy diets, non-smoking, reduced alcohol consumption and stress reduction are important in the prevention of metabollic CVD risk factors such as hypertension, overweight and obesity, diabetes and hyperlipidaemia. Owing to current lifestyle changes, the increasing burden of CVD and importance of healthy behaviours, the need for strategies to increase uptake of healthy lifestyles among sub-Saharan African populations are apparent. This study explored the factors influencing uptake of healthy lifestyle practices among adults following implementation of a community CVD prevention programme. Methods This was a descriptive qualitative study conducted among purposively selected adults who had engaged in a community CVD prevention programme. Data were collected using in-depth interviews, which were audio recorded and transcribed verbatim. Study transcripts were read into NVIVO 12.6 software for coding and analysis guided by thematic analysis following the semantic approach. Results This study found variations in uptake of healthy lifestyle practices for CVD prevention with most changes reported for dietary behaviour especially in vegetable and fruit intake, reduction of salt intake and fats and oils consumption. Changes in physical activity were also notable. On the other hand, participants were slow in making changes in alcohol consumption, smoking behaviours and stress reduction. The barriers to uptake of healthy lifestyle practices were individual such as limited capability or skills, structural such as limited physical activity facilities, and social such as cultural and peer influence. Relatedly, the facilitators of practices uptake were individual including knowledge and personal determination to change, and social including social support from family and the community. Conclusions Insights from understanding the uptake of lifestyle practices should guide planning and design of community programmes with an emphasis on removing barriers and ...
Keywords	Medicine ; R ; Science ; Q
Subject code	360
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Understanding factors influencing uptake of healthy lifestyle practices among adults following a community cardiovascular disease prevention programme in Mukono and Buikwe districts in Uganda

Rawlance Ndejjo / Geofrey Musinguzi / Fred Nuwaha / Hilde Bastiaens / Rhoda K Wanyenze

PLoS ONE, Vol 17, Iss 2, p e

A qualitative study.

2022 Volume 0263867

Abstract	Introduction Healthy lifestyle practices including physical activity, healthy diets, non-smoking, reduced alcohol consumption and stress reduction are important in the prevention of metabollic CVD risk factors such as hypertension, overweight and obesity, diabetes and hyperlipidaemia. Owing to current lifestyle changes, the increasing burden of CVD and importance of healthy behaviours, the need for strategies to increase uptake of healthy lifestyles among sub-Saharan African populations are apparent. This study explored the factors influencing uptake of healthy lifestyle practices among adults following implementation of a community CVD prevention programme. Methods This was a descriptive qualitative study conducted among purposively selected adults who had engaged in a community CVD prevention programme. Data were collected using in-depth interviews, which were audio recorded and transcribed verbatim. Study transcripts were read into NVIVO 12.6 software for coding and analysis guided by thematic analysis following the semantic approach. Results This study found variations in uptake of healthy lifestyle practices for CVD prevention with most changes reported for dietary behaviour especially in vegetable and fruit intake, reduction of salt intake and fats and oils consumption. Changes in physical activity were also notable. On the other hand, participants were slow in making changes in alcohol consumption, smoking behaviours and stress reduction. The barriers to uptake of healthy lifestyle practices were individual such as limited capability or skills, structural such as limited physical activity facilities, and social such as cultural and peer influence. Relatedly, the facilitators of practices uptake were individual including knowledge and personal determination to change, and social including social support from family and the community. Conclusions Insights from understanding the uptake of lifestyle practices should guide planning and design of community programmes with an emphasis on removing barriers and ...
Keywords	Medicine ; R ; Science ; Q
Subject code	360
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Secondary distribution of HIV self-test kits from males to their female sexual partners in two fishing communities in rural Uganda

Joseph K. B. Matovu / Linda Kemigisha / Geoffrey Taasi / Joshua Musinguzi / Rhoda K. Wanyenze / David Serwadda

PLOS Global Public Health, Vol 3, Iss

2023 Volume 11

Keywords	Public aspects of medicine ; RA1-1270
Language	English
Publishing date	2023-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Harnessing digital technology for COVID-19 response in Uganda

Rawlance Ndejjo / Steven Ndugwa Kabwama / Rhoda K Wanyenze / Andrew K Tusubira / Alice Namale / Irene Wanyana / Susan Kizito / Suzanne N Kiwanuka

BMJ Global Health, Vol 8, Iss Suppl

lessons and implications for future public health emergencies

2023 Volume 6

Keywords	Medicine (General) ; R5-920 ; Infectious and parasitic diseases ; RC109-216
Language	English
Publishing date	2023-10-01T00:00:00Z
Publisher	BMJ Publishing Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Drivers of cardiovascular disease risk factors in slums in Kampala, Uganda

Rawlance Ndejjo / Paineto Masengere / Douglas Bulafu / Lydia Nabawanuka Namakula / Rhoda K. Wanyenze / David Musoke / Geofrey Musinguzi

Global Health Action, Vol 16, Iss

a qualitative study

2023 Volume 1

Abstract: Background Cardiovascular disease (CVD) risk factors are increasing in many sub-Saharan African countries and disproportionately affecting communities in urban slums. Despite this, the contextual factors that influence CVD risk among slum communities ... ...

Abstract	Background Cardiovascular disease (CVD) risk factors are increasing in many sub-Saharan African countries and disproportionately affecting communities in urban slums. Despite this, the contextual factors that influence CVD risk among slum communities have not been fully documented to guide interventions to prevent and control the disease. Objective This study explored the drivers of CVD risk factors in slums in Kampala, Uganda. Methods This qualitative study employed focus group discussions (FGDs) to collect data among slum residents. A total of 10 FGDs separate for gender and age group were held in community public places. Discussions were audio-recorded, transcribed, and transcripts analysed thematically with the aid of Atlas ti 7.0. Study themes and sub-themes are presented supported by participant quotations. Results Five themes highlighted the drivers of CVD risk factors in slum communities. (1) Poverty: a critical underlying factor which impacted access and choice of food, work, and housing. (2) Poverty-induced stress: a key intermediate factor that led to precarious living with smoking and alcohol use as coping measures. (3) The social environment which included socialisation through drinking and smoking, and family and peers modelling behaviours. (4) The physical environment such as the high availability of affordable alcohol and access to amenities for physical activity and healthy foods. (5) Knowledge and information about CVD risk factors which included understanding of a healthy diet and the dangers of smoking and alcohol consumption. Conclusion To address CVD risk in slums, broad-ranging multisectoral interventions are required, including economic empowerment of the slum population, stress reduction and coping interventions, and alcohol legislation. Also, there is a need for community CVD sensitisation and screening as well as increasing access to physical activity amenities and healthy foods within slums.
Keywords	alcohol ; diet ; physical activity ; smoking ; slums ; Public aspects of medicine ; RA1-1270
Subject code	910
Language	English
Publishing date	2023-12-01T00:00:00Z
Publisher	Taylor & Francis Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Peer-leaders’ experiences and challenges in distributing HIV self-test kits in a rural fishing community, Rakai, Uganda

Joseph K. B. Matovu / Aminah Nambuusi / Rhoda K. Wanyenze / David Serwadda

BMC Public Health, Vol 21, Iss 1, Pp 1-

2021 Volume 12

Abstract: Abstract Background Distribution of HIV self-test kits by trained lay people in the community has resulted in increased uptake of HIV testing services among the targeted populations. However, little data exists on the experiences and challenges faced by ... ...

Abstract	Abstract Background Distribution of HIV self-test kits by trained lay people in the community has resulted in increased uptake of HIV testing services among the targeted populations. However, little data exists on the experiences and challenges faced by trained lay people while distributing the kits. Methods This qualitative study was conducted in Kasensero fishing community, Rakai, Uganda, in September 2019. We purposely selected 18 out of 34 peer-leaders that participated in a peer-led HIV self-testing intervention to participate in a post-intervention qualitative evaluation. The main intervention included identification and training of lay people in the community (‘peer-leaders’) to distribute HIV self-test kits to pre-selected members of their social network. Data for this study were collected at the end of the intervention. Data were collected on peer-leaders’ experiences in distributing the kits, challenges experienced during distribution and suggestions on how to improve peer-led HIV self-testing in typical fishing communities in the future. Data were analyzed manually following a thematic framework approach. Results Of the 18 peer-leaders, eleven (61.1%) were aged 20–24 years while thirteen (72.2%) had secondary education. Most (n = 15) of the peer-leaders reported that they found it easier to distribute the kits to their social network members, with most of them distributing the kits at the social network members’ homes or at their own homes. HIV self-test kits were distributed at varying times (e.g. in the afternoon) depending on the agreement reached between the peer-leader and their social network member. A few peer-leaders reported that some of their social network members initially hesitated to accept the kits while other peer-leaders reported that they spent a ‘lot of time’ explaining the HIV self-testing procedures to some of their illiterate members. Peer-leaders argued for supervised HIV self-testing for illiterate people and the need to continuously follow-up social network members to check if ...
Keywords	HIV self-testing ; Peer-leaders ; Social network members ; Public aspects of medicine ; RA1-1270
Subject code	303 ; 306
Language	English
Publishing date	2021-04-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Alcohol use and associated factors among adolescent boys and young men in Kampala, Uganda

Steven Ndugwa Kabwama / Joseph KB Matovu / John M Ssenkusu / Tonny Ssekamatte / Rhoda K. Wanyenze

Substance Abuse Treatment, Prevention, and Policy, Vol 16, Iss 1, Pp 1-

2021 Volume 9

Abstract: Abstract Background Alcohol use leads to about 3 million deaths globally. The alcohol industry employs marketing strategies to establish their brands in the lives of young people at a time when addictive behaviors are initiated and reinforced. We ... ...

Abstract	Abstract Background Alcohol use leads to about 3 million deaths globally. The alcohol industry employs marketing strategies to establish their brands in the lives of young people at a time when addictive behaviors are initiated and reinforced. We conducted a survey among adolescent boys and young men (ABYM) to estimate the prevalence of alcohol use and associated factors using the Health Belief Model as the guiding framework. Methods The study was conducted among ABYM in- or out-of-school aged 10–24 years in Kampala, Uganda. We used questions adopted from the Global School-based Student Health Survey and the WHO STEPwise approach to Surveillance questionnaire to collect data. The outcome of interest was alcohol use within 30 days before the interview. We also asked about characteristics such as alcohol use by siblings, parents/ guardians, school status among others. We used odds ratios obtained via a logistic regression model as the measure of association. Results A total of 2500 ABYM participated, of which 262 (10.5 %, 95 %CI 9.3–11.7) had consumed alcohol within 30 days before the interview. Out-of-school ABYM had higher odds of consuming alcohol compared with their in-school counterparts AOR 1.55 (95 %CI 1.09–2.20). Compared with ABYM whose parents/ guardians did not drink alcohol, ABYM whose both parents consumed alcohol had higher odds of consuming alcohol AOR 2.24 (95 %CI 1.38–3.64) as were those with only a mother or female guardian who consumed alcohol AOR 1.95 (95 %CI 1.11–3.41). ABYM with siblings that drink alcohol had higher odds of consuming alcohol AOR 2.25 (95 %CI 1.80–3.52). ABYM who possessed items with an alcohol brand logo had higher odds of consuming alcohol AOR 2.00 (95 %CI 1.33–3.01). Conclusions There are significant levels of alcohol consumption among ABYM which calls for evidence-based measures targeting this age group to reduce consumption and recognizing the role of the family, school and community in prevention and promotion of use. There is need to regulate alcohol marketing and ...
Keywords	Alcohol ; adolescents ; young men ; Uganda ; Public aspects of medicine ; RA1-1270 ; Social pathology. Social and public welfare. Criminology ; HV1-9960
Subject code	310 ; 360
Language	English
Publishing date	2021-06-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Positioning Africa’s public health doctoral students to lead societal transformation and development

Jimmy Osuret / Esther Bayiga Zziwa / Sharon Fonn / Charles Ssemugabo / Tobias Alfvén / Rawlance Ndejjo / Meleckidzedeck Khayesi / David Mukanga / Rhoda K. Wanyenze

BMJ Global Health, Vol 7, Iss

2022 Volume 2

Keywords	Medicine (General) ; R5-920 ; Infectious and parasitic diseases ; RC109-216
Language	English
Publishing date	2022-02-01T00:00:00Z
Publisher	BMJ Publishing Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Unintended socio-economic and health consequences of COVID-19 among slum dwellers in Kampala, Uganda

Rebecca Nuwematsiko / Maxencia Nabiryo / John Bosco Bomboka / Sarah Nalinya / David Musoke / Daniel Okello / Rhoda K. Wanyenze

BMC Public Health, Vol 22, Iss 1, Pp 1-

2022 Volume 13

Abstract: Abstract Background To reduce the spread of COVID-19, several countries in Africa instituted countrywide lockdowns and other public health measures. Whereas lockdowns contributed to the control of the pandemic, there were concerns about the unintended ... ...

Abstract	Abstract Background To reduce the spread of COVID-19, several countries in Africa instituted countrywide lockdowns and other public health measures. Whereas lockdowns contributed to the control of the pandemic, there were concerns about the unintended consequences of these measures especially in the most vulnerable populations. We assessed unintended socio-economic and health consequences due to the COVID-19 pandemic and the mitigation measures among slum dwellers in Kampala to inform the on-going and future pandemic response strategies. Methods This was a mixed methods cross-sectional study conducted in Bwaise I and Bwaise III slums of Kawempe division, Kampala Uganda from October to December 2020. We used systematic sampling to randomly select 425 household heads for the face-to-face quantitative interviews. We also conducted six focus group discussions (FGDs) with slum dwellers and used photovoice among eight Community Health Workers (CHWs) to document unintended socio-economic and health consequences. Quantitative data were imported into STATA version 14.0 for analysis, while qualitative data were analysed thematically using NVivo version 12. Modified Poisson regression analysis was conducted to establish factors associated with impact on access to food. Results Most respondents reported limited access to food (71.1%; 302/425); disruption in education (77.1%; 270/350); drop in daily income and wages (86.1%; 329/382) and loss of employment (63.1; 125/198). Twenty five percent of the respondents (25.4%; 86/338) reported domestic violence as one of the challenges. Seven themes emerged from the qualitative findings on the impact of COVID-19 including: limited access to food; negative impact on children’s rights (child labour and teenage pregnancies) and education; poor housing and lack of accommodation; negative social behaviours; negative impact on family and child care; reduced income and employment; and negative impact on health and access to health care services. Conclusion The slum dwellers of Bwaise I and ...
Keywords	Photovoice ; Unintended consequences ; COVID-19 ; Slum dwellers ; Public aspects of medicine ; RA1-1270
Subject code	360
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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