Community interventions in landslide scar use in the upper Manafwa catchment, Eastern Uganda

Abstract Background Globally, 15 million neonates are born prematurely every year, over half in low income countries (LICs). Premature and low birth weight neonates have a higher risk of intraventricular haemorrhage (IVH). There are minimal data regarding IVH in sub-Saharan Africa. This study aimed to examine the incidence, severity and timing of and modifiable risk factors for IVH amongst low-birth-weight neonates in Uganda. Methods This is a prospective cohort study of neonates with birthweights of ≤2000 g admitted to a neonatal unit (NU) in a regional referral hospital in eastern Uganda. Maternal data were collected from interviews and medical records. Neonates had cranial ultrasound (cUS) scans on the day of recruitment and days 3, 7 and 28 after birth. Risk factors were tabulated and are presented alongside odds ratios (ORs) and adjusted odds ratios (aORs) for IVH incidence. Outcomes included incidence, timing and severity of IVH and 28-day survival. Results Overall, 120 neonates were recruited. IVH was reported in 34.2% of neonates; 19.2% had low grade (Papile grades 1–2) and 15% had high grade (Papile grades 3–4). Almost all IVH (90.2%) occurred by day 7, including 88.9% of high grade IVH. Of those with known outcomes, 70.4% (81/115) were alive on day 28 and survival was not associated with IVH. We found that vaginal delivery, gestational age (GA) < 32 weeks and resuscitation in the NU increased the odds of IVH. Of the 6 neonates who received 2 doses of antenatal steroids, none had IVH. Conclusion In this resource limited NU in eastern Uganda, more than a third of neonates born weighing ≤2000 g had an IVH and the majority of these occurred by day 7. We found that vaginal birth, earlier gestation and need for resuscitation after admission to the NU increased the risk of IVH. This study had a high rate of SGA neonates and the risk factors and relationship of these factors with IVH in this setting needs further investigation. The role of antenatal steroids in the prevention of IVH in LICs also needs urgent exploration.

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Commercial Sugarcane Farming in Eastern Uganda: the answer to vulnerable youth?

Eastern Africa Social Science Research Review ◽

10.1353/eas.2021.0000 ◽

2021 ◽

Vol 37 (1) ◽

pp. 1-25

Author(s):

Kassim Mwanika ◽

Andrew Ellias State ◽

Peter Atekyereza ◽

Torun Osterberg

Keyword(s):

Vulnerable Youth ◽

Sugarcane Farming ◽

Eastern Uganda

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“… I would have left that man long time ago but, …” exploring circumstances of and motivators for repeat adolescent birth in Eastern Uganda

Archives of Public Health ◽

10.1186/s13690-021-00662-9 ◽

2021 ◽

Vol 79 (1) ◽

Author(s):

Dinah Amongin ◽

Frank Kaharuza ◽

Claudia Hanson ◽

Annettee Nakimuli ◽

Susan Mutesi ◽

...

Keyword(s):

Adolescent Mothers ◽

Dropping Out ◽

First Birth ◽

Economic Distress ◽

Contraception Use ◽

Long Time ◽

Adolescent Birth ◽

Unprotected Sexual Activity ◽

Depth Interviews ◽

Eastern Uganda

Abstract Background First birth before 18 years has declined in Uganda unlike repeat adolescent birth (=second or more births before age 20 years). We explored the circumstances of and motivators for repeat adolescent birth in Eastern Uganda. Methods Between January and March 2020, we conducted a qualitative study involving 70 individual in-depth interviews with purposively selected respondents - 20-25-year-old women with and without repeat adolescent birth, their partners, and parents, in the communities of Teso sub-region. We conducted latent content analysis. Results Four major themes emerged: poverty, vulnerability, domestic violence, and demotivators. Sub-themes identified under poverty were: “limited provisions”, “peasantry”, “large families”, “dropping out of school”, “alcohol abuse”, and “broken family structure”. Vulnerability included “marital entrapment” and “partner coercion”. Demotivators included: “abandonment”, “stern warning”, “objection to marriage”, and “empowerment”. Extreme poverty resulted in inadequate provision of basic needs leading to unprotected sexual activity in a bid to secure financial support. Following the first birth, more than three quarters of the women with repeat adolescent birth reported increased economic distress that forced them to remain in unwanted marriage/union, often characterized by partner coercion, despite wanting to delay that repeat birth. Women without repeat adolescent birth avoided a second birth by empowerment through: an economic activity, contraception use, and resumption of schooling. Conclusion Repeat adolescent birth in Uganda is premised around attempts to address the economic distress precipitated by first birth. Many women want to delay that repeat birth but the challenges robbed them of their reproductive autonomy. Beyond efforts to prevent first birth, programs need to address economic empowerment, ensure contraceptive access, and school re-integration for adolescent mothers in order to prevent shortly-spaced repeat births.

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