Mobility for maternal health among women in hard-to-reach fishing communities on Lake Victoria, Uganda; a community-based cross-sectional survey

Abstract Background Maternal mortality is still a challenge in Uganda, at 336 deaths per 100,000 live births, especially in rural hard to reach communities. Distance to a health facility influences maternal deaths. We explored women’s mobility for maternal health, distances travelled for antenatal care (ANC) and childbirth among hard-to-reach Lake Victoria islands fishing communities (FCs) of Kalangala district, Uganda. Methods A cross sectional survey among 450 consenting women aged 15–49 years, with a prior childbirth was conducted in 6 islands FCs, during January-May 2018. Data was collected on socio-demographics, ANC, birth attendance, and distances travelled from residence to ANC or childbirth during the most recent childbirth. Regression modeling was used to determine factors associated with over 5 km travel distance and mobility for childbirth. Results The majority of women were residing in communities with a government (public) health facility [84.2 %, (379/450)]. Most ANC was at facilities within 5 km distance [72 %, (157/218)], while most women had travelled outside their communities for childbirth [58.9 %, (265/450)]. The longest distance travelled was 257.5 km for ANC and 426 km for childbirth attendance. Travel of over 5 km for childbirth was associated with adolescent girls and young women (AGYW) [AOR = 1.9, 95 % CI (1.1–3.6)], up to five years residency duration [AOR = 1.8, 95 % CI (1.0-3.3)], and absence of a public health facility in the community [AOR = 6.1, 95 % CI (1.4–27.1)]. Women who had stayed in the communities for up to 5 years [AOR = 3.0, 95 % CI (1.3–6.7)], those whose partners had completed at least eight years of formal education [AOR = 2.2, 95 % CI (1.0-4.7)], and those with up to one lifetime birth [AOR = 6.0, 95 % CI (2.0-18.1)] were likely to have moved to away from their communities for childbirth. Conclusions Despite most women who attended ANC doing so within their communities, we observed that majority chose to give birth outside their communities. Longer travel distances were more likely among AGYW, among shorter term community residents and where public health facilities were absent. Trial registration PACTR201903906459874 (Retrospectively registered). https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=5977.

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Antenatal Care Practices Among Hard-to-Reach Fishing Communities on Lake Victoria: A Community-Based Cross-Sectional Survey

Journal of Primary Care & Community Health ◽

10.1177/2150132720923101 ◽

2020 ◽

Vol 11 ◽

pp. 215013272092310 ◽

Cited By ~ 1

Author(s):

Ali Ssetaala ◽

Joan Nabawanuka ◽

Gideon Matovu ◽

Nusula Nakiragga ◽

Judith Namugga ◽

...

Keyword(s):

Antenatal Care ◽

Lake Victoria ◽

Public Health Facility ◽

Adverse Outcomes ◽

Sub Saharan Africa ◽

Fishing Communities ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Care Community ◽

Late Start

Background: Uganda has one of the highest maternal deaths in sub-Saharan Africa, with a mortality ratio of 336 per 100 000 live births. Early regular antenatal care (ANC) helps prevent adverse outcomes, including deaths, through prevention, identification, treatment, and/or referral of at-risk women. We explored ANC practices and associated factors among women from hard-to-reach Lake Victoria islands fishing communities in Kalangala district, Uganda. Methods: A cross-sectional survey among 486 consenting women aged 15 to 49 years, who were pregnant or had a birth or abortion in the past 6 months was conducted in 6 island fishing communities of Kalangala district, Uganda, during January to May 2018. ODK software interviewer-administered questionnaires were used to collect data on sociodemographics and ANC practices. Regression modeling using STATA version 15 was used to determine factors associated with ANC visits. Results: Women’s median (range) age was 26 (15-45) years, 63% (304/486) had up to primary level education, 45% (219/486) were housewives (stay home mums), 87% (423/486) were married. ANC visits ranged from 0 to 10, with over three-fifths of women having their first visit late after 3 months of being pregnant (63%, 198/316). Women without a history of pregnancy loss (adjusted odds ratio [AOR] = 1.8, 95% CI 1.1-3.0), those not staying with their partners (AOR = 2.5, 95% CI 1.1-6.0), and those whose partners were working in fishing-related activities (AOR = 1.8, 95% CI 1.0-3.0) were likely to have started care late. Women from communities with a public health facility and those with partners working in none fishing-related activities had the highest predicted number of visits. Conclusion: Antenatal practices among these communities are characterized by late start of care. Community-led early ANC awareness interventions are needed. Targeted health policies need to consider public ANC facilities for each island for improved antenatal outcomes and maternal health.

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Correlates of family planning knowledge among people in fishing communities of Lake Victoria in Uganda

10.21203/rs.3.rs-15612/v1 ◽

2020 ◽

Author(s):

Annet Nanvubya ◽

R.K. Wanyenze ◽

T. Nakaweesa ◽

J. Mpendo ◽

B. Kawoozo ◽

...

Keyword(s):

Family Planning ◽

Side Effects ◽

Hiv Prevention ◽

Lake Victoria ◽

Cultural Beliefs ◽

Fishing Communities ◽

Modern Contraceptive ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Prevention Trials

Abstract BackgroundFamily planning (FP) is a key component in the conduct of HIV prevention trials and FP knowledge is a determinant of modern contraceptive use. Although fishing communities (FCs) participate in HIV prevention trials, knowledge about FP in this population is scarcely known. We determined correlates of FP knowledge in FCs of L. Victoria in Uganda to inform improvements in FP interventions in preparation for other HIV prevention trials.MethodsWe conducted a cross-sectional survey among participants aged 16-49 years in Kigungu and Nsazi FCs. A semi-structured questionnaire was administered to assess FP knowledge. A composite score with 5 parameters including; awareness about FP methods, knowledge about ideal number of children for a couple, knowledge about ideal birth spacing interval, knowledge about FP methods and their side effects and interval between the last 2 children was used to determine whether participant’s knowledge was or wasn’t satisfactory. Satisfactory FP knowledge was attributed to a score of ≥80% from the five parameters. We also conducted 10 in-depth interviews and 4 focus group discussions.ResultsOf the 1,410 screened participants, 95% were aware of at least one FP method while only 21% had satisfactory knowledge. Participants aged 30-39 years, those engaged in trade/business, housewives, those from Nsazi, the married or those who were divorced, separated or widowed were more likely to have satisfactory FP knowledge compared to those aged 16-29 years (aOR: 1.59 95% CI: 1.14-2.22), farmers (aOR: 3.14 95% CI: 1.21-8.17), and (aOR: 3.69 95% CI: 1.35-10.1), those from Kigungu (aOR: 1.58 95%CI: 1.09-2.30), those who were single (aOR: 6.96 95% CI: 3.42-14.13) or (aOR: 17.67 95% CI: 8.54-36.54).There were concerns about side effects and effectiveness of some modern FP methods. Misconceptions about effects of FP like sterility, cancers and foetal abnormalities were common. Cultural beliefs on contraception are key barriers to FP information.ConclusionPeople from FCs in Uganda are aware of FP but their knowledge is largely unsatisfactory. Concerns about method safety, effectiveness of some methods, misconceptions and cultural barriers exist. A FP education tool tailored for a mobile, high risk and remote population is recommended to improve FP knowledge.

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Components of antenatal care received by women in fishing communities on Lake Victoria, Uganda; a cross sectional survey

10.21203/rs.3.rs-20221/v3 ◽

2020 ◽

Author(s):

Ali Ssetaala ◽

Joan Nabawanuka ◽

Gideon Matovu ◽

Nusula Nakiragga ◽

Judith Namugga ◽

...

Keyword(s):

Antenatal Care ◽

Health Workers ◽

Lake Victoria ◽

Cost Effective ◽

Fishing Communities ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Island Communities ◽

Development Goals ◽

Victoria Island

Abstract Background: Uganda has one of the highest maternal deaths at a ratio of 336 per 100,000 live births. As Uganda strives to achieve sustainable development goals, appropriate antenatal care is key to reduction of maternal mortality. We explored women’s reported receipt of seven of the Uganda guidelines components of antenatal care, and associated factors in hard to reach Lake Victoria island fishing communities of Kalangala district.Methods: A cross sectional survey among 486 consenting women aged 15-49 years, who were pregnant at any time in the past 6 months was conducted in 6 island fishing communities of Kalangala district, Uganda, during January-May 2018. Interviewer administered questionnaires, were used to collect data on socio-demographics and receipt of seven of the Uganda guidelines components of antenatal care. Regression modeling was used to determine factors associated with receipt of all seven components. Results: Over three fifths (65.0%) had at least one ANC visit during current or most recent pregnancy. Fewer than a quarter of women who reported attending care at least four times received all seven ANC components [(23.6%), P<0.05]. Women who reported receipt of ANC from the mainland were twice as likely to have received all seven components as those who received care from islands (aOR=1.8; 95% CI:0.9-3.7). Receipt of care from a doctor was associated with thrice likelihood of receiving all components relative to ANC by a midwife or nurse (aOR=3.2; 95% CI:1.1-9.1). Conclusions: We observed that the delivery of antenatal care components per Ugandan guidelines is poor in these communities. Cost effective endeavors to improve components of antenatal care received by women are urgently needed. Task shifting some components of ANC to community health workers may improve care in these island communities.Trial Registration: PACTR201903906459874 (Retrospectively registered).

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Components of antenatal care received by women in fishing communities on Lake Victoria, Uganda; a cross sectional survey

10.21203/rs.3.rs-20221/v2 ◽

2020 ◽

Author(s):

Ali Ssetaala ◽

Joan Nabawanuka ◽

Gideon Matovu ◽

Nusula Nakiragga ◽

Judith Namugga ◽

...

Keyword(s):

Antenatal Care ◽

Health Workers ◽

Lake Victoria ◽

Cost Effective ◽

Fishing Communities ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Island Communities ◽

Development Goals ◽

Victoria Island

Abstract Background: Uganda has one of the highest maternal deaths at a ratio of 336 per 100,000 live births. As Uganda strives to achieve sustainable development goals, appropriate antenatal care is key to reduction of maternal mortality. We explored women’s reported receipt of seven of the Uganda guidelines components of antenatal care, and associated factors in hard to reach Lake Victoria island fishing communities of Kalangala district. Methods: A cross sectional survey among 486 consenting women aged 15-49 years, who were pregnant at any time in the past 6 months was conducted in 6 island fishing communities of Kalangala district, Uganda, during January-May 2018. Interviewer administered questionnaires, were used to collect data on socio-demographics and receipt of seven of the Uganda guidelines components of antenatal care. Regression modeling was used to determine factors associated with receipt of all seven components. Results: Over three fifths (65.0%) had at least one ANC visit during current or most recent pregnancy. Fewer than a quarter of women who reported attending care at least four times received all seven ANC components [(23.6%), P<0.05]. Women who reported receipt of ANC from the mainland were twice as likely to have received all seven components as those who received care from islands (aOR=1.8; 95% CI:0.9-3.7). Receipt of care from a doctor was associated with thrice likelihood of receiving all components relative to ANC by a midwife or nurse (aOR=3.2; 95% CI:1.1-9.1). Conclusions: We observed that the delivery of antenatal care components per Ugandan guidelines is poor in these communities. Cost effective endeavors to improve components of antenatal care received by women are urgently needed. Task shifting some components of ANC to community health workers may improve care in these island communities. Trial Registration: PACTR201903906459874 (Retrospectively registered).

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Out of pocket expenditure for availing maternal health care services in Northern India

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.246 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

A Singh ◽

P Jain ◽

S Kumar ◽

S Singh ◽

N Singh

Keyword(s):

Public Health ◽

Health Care ◽

Maternal Health ◽

Health Facility ◽

Health Care Services ◽

Public Health Facility ◽

Maternal Health Care ◽

Health Care Facilities ◽

Care Services ◽

Maternal Health Care Services

Abstract Introduction Maternal and child health comprise one of the most important parameters of the health situation in a country at any given time. Maternal and new born child's health are inter-related to a great extent and while improving one, we might greatly affect the other; hence, joint efforts are required to cope with the rising demands of better healthcare for both. Out-of-pocket expenditure act as a major deterrent, especially to underprivileged communities, in accessibility to maternal health care services and knowledge of the determinants of maternity related expenses helps in outlining policies. Material and Methods This is a community based cross sectional study conducted in state of Uttar Pradesh between July 2019 to December 2019 among 848 women who delivered in past six months at a public health facility. A pretested, semi structured questionnaire was used to collect data. The data thus collected was entered into Microsoft Excel spreadsheet and was analysed using Statistical Package for Social Sciences (SPSS) version 24.0, IBM Inc. Chicago, USA software. Results The analysis showed that the median OOPE was INR 1000 (US$ 13.89) which varied between INR 950 (US$ 13.19) for normal delivery and INR 4900 (US$ 68) for caesarean section. OOPE for availing diagnostic facilities especially ultrasound with a median value of INR 500 (US$ 6.94) contributed to the major share. Women from households with income more than INR 7500 (US$ 104.17) per month, education higher than high school, primi-gravida, occupation of mother and type of delivery were significant predictors for high OOPE. Awareness level about various free entitlements in public health facility was significantly associated with overall out of pocket expenditure. Conclusions Although services at the public health facility in India are supposedly provided free of cost, considerable out of pocket expenditure is still incurred on beneficiaries while availing maternity services. Key messages Out of pocket expenditure is a major deterrent in availing institutional deliveries in public health facilities. Zero-cost, equitable and accessible maternal health care services through timely access to health care facilities is of paramount importance for reducing MMR and IMR in every country.

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Correlates of knowledge of family planning among people living in fishing communities of Lake Victoria, Uganda

10.21203/rs.3.rs-15612/v4 ◽

2020 ◽

Author(s):

Annet Nanvubya ◽

R.K. Wanyenze ◽

T. Nakaweesa ◽

J. Mpendo ◽

B. Kawoozo ◽

...

Keyword(s):

Family Planning ◽

Clinical Research ◽

Lake Victoria ◽

Good Knowledge ◽

Fishing Communities ◽

Access To Health Services ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Poor Knowledge ◽

The Mean

Abstract Knowledge of family planning (FP) is a key determinant of contraceptive use which ultimately plays a role in attainment of good health and in conduct of clinical research. People living in fishing communities (FCs) have limited access to health services including FP and are targeted for future clinical research but their knowledge of FP and its correlates are scantily known. We determined correlates of knowledge of FP among people living in FCs of L. Victoria in Uganda to inform future FP education programs in FCs. We conducted a comparative cross-sectional survey among participants aged 15-49 years from Kigungu and Nsazi. Participants were asked if they were aware of any FP method. All those who responded in the affirmative were further asked to mention what FP methods they had heard of or knew. Those who reported knowledge of at least one FP method were asked a series of questions about FP methods and their side effects. Knowledge was categorized into good or poor knowledge based on their mean total score. Poor knowledge constituted a score below the mean while good knowledge constituted a score of more than or equal to the mean total score. To further explore attitudes and perceptions of FP, ten in-depth interviews and four focus group discussions were conducted. Of the 1,410 screened participants, 94.5% were aware of at least one FP method. Pills and injectable hormonal methods were the most commonly known methods. Slightly over a third (38%) had good knowledge of FP. Correlates of knowledge of FP were; being female (aOR: 1.92 95% CI: 1.39-2.67), residing in Kigungu (aOR: 4.01 95% CI: 2.77-5.81), being married (aOR: 1.59 95% CI: 1.11-2.28) and currently being in a sexual relationship (aOR: 1.75 95% CI: 1.18-2.60). Concerns about safety and effectiveness of some modern FP methods exist. Misconceptions on effects of FP like sterility, cancers and foetal abnormalities were common. FP awareness among people living in FCs of L. Victoria in Uganda is high. However, good knowledge about specific methods tends to be low. Correlates of knowledge of FP include gender, residence, marital status and sexual engagement.

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Correlates of knowledge of family planning among people living in fishing communities of Lake Victoria, Uganda

BMC Public Health ◽

10.1186/s12889-020-09762-7 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Annet Nanvubya ◽

Rhoda K. Wanyenze ◽

Teddy Nakaweesa ◽

Juliet Mpendo ◽

Barbarah Kawoozo ◽

...

Keyword(s):

Family Planning ◽

Clinical Research ◽

Lake Victoria ◽

Good Knowledge ◽

Fishing Communities ◽

Access To Health Services ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Poor Knowledge ◽

The Mean

Abstract Background Knowledge of family planning (FP) is a key determinant of contraceptive use which ultimately plays a role in attainment of good health and in conduct of clinical research. People living in fishing communities (FCs) have limited access to health services including FP and are targeted for future clinical research but their knowledge of FP and its correlates are scantily known. We determined correlates of knowledge of FP among people living in FCs of L. victoria in Uganda to inform future FP education programs in FCs. Methods We conducted a comparative cross-sectional survey among participants aged 15–49 years from Kigungu and Nsazi. Participants were asked if they were aware of any FP method. All those who responded in the affirmative were further asked to mention what FP methods they had heard of or knew. Those who reported knowledge of at least one FP method were asked a series of questions about FP methods and their side effects. Knowledge was categorized into good or poor knowledge based on their mean total score. Poor knowledge constituted a score below the mean while good knowledge constituted a score of more than or equal to the mean total score. To further explore attitudes and perceptions of FP, ten in-depth interviews and four focus group discussions were conducted. Results Of the 1410 screened participants, 94.5% were aware of at least one FP method. Pills and injectable hormonal methods were the most commonly known methods. Slightly over a third (38%) had good knowledge of FP. Correlates of knowledge of FP were; being female (aOR: 1.92 95% CI: 1.39–2.67), residing in Kigungu (aOR: 4.01 95% CI: 2.77–5.81), being married (aOR: 1.59 95% CI: 1.11–2.28) and currently being in a sexual relationship (aOR: 1.75 95% CI: 1.18–2.60). Concerns about safety and effectiveness of some modern FP methods exist. Misconceptions on effects of FP like sterility, cancers and foetal abnormalities were common. Conclusion FP awareness among people living in FCs of L. Victoria in Uganda is high. However, good knowledge about specific methods tends to be low. Correlates of knowledge of FP include gender, residence, marital status and sexual engagement.

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Barriers and Facilitators of Family Planning Use in Fishing Communities of Lake Victoria in Uganda

Journal of Primary Care & Community Health ◽

10.1177/2150132720943775 ◽

2020 ◽

Vol 11 ◽

pp. 215013272094377 ◽

Cited By ~ 1

Author(s):

Annet Nanvubya ◽

Rhoda Kitty Wanyenze ◽

Onesmus Kamacooko ◽

Teddy Nakaweesa ◽

Juliet Mpendo ◽

...

Keyword(s):

Family Planning ◽

Lake Victoria ◽

Cultural Influences ◽

Sexual Partners ◽

Barriers And Facilitators ◽

Fishing Communities ◽

Gender Preferences ◽

Cross Sectional Survey ◽

Excessive Bleeding ◽

Cross Sectional

Introduction: Family planning (FP) is a key element in the conduct of research and is essential in managing family sizes. Although fishing communities (FCs) are targeted populations for HIV prevention research, their FP practices are poorly understood. We explored barriers and facilitators of FP use in FCs of Lake Victoria in Uganda. Methods: We employed a mixed-methods approach comprising a cross-sectional survey, in-depth interviews, and focus group discussions in 2 FCs. Multivariable logistic regression was used to analyze quantitative data and a thematic approach to generate themes from the qualitative data. Results: Up to 1410 individuals participated in the survey and 47 in the qualitative study. Just over a third (35.6%) used FP. The most commonly used methods were condoms, pills, and injectables. In Kigungu community, participants whose religion was Anglican and Muslim were more likely to use FP than Catholics (adjusted odds ratio [aOR] 1.45; 95% CI 1.05-1.99 and aOR 1.45; 95% CI 1.05-2.07, respectively). Participants were more likely to use FP if they had satisfactory FP knowledge compared to those with no satisfactory FP knowledge (aOR 1.79; 95% CI 1.23-2.61), or if they were married compared to their single counterparts (aOR 1.84; 95% CI 1.32-2.57). In both communities, participants were more likely to use FP if they had 2 or more sexual partners in the past 12 months than those with less than 2 sexual partners (aOR 1.41 95% CI 1.07-1.87 and aOR 2.60; 95% CI 1.36-4.97). Excessive bleeding and delayed fecundity; fertility desire; gender preferences of children; method stock outs and lack of FP trained personnel constituted barriers to FP use. There were also cultural influences in favor of large families. Conclusion: FP use in FCs is suboptimal. Barriers of FP use were mainly biomedical, religious, social, and cultural, which underscores a need for FP education and strengthening of FP service provision in FCs.

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Components of antenatal care received by women in fishing communities on Lake Victoria, Uganda; a cross sectional survey

10.21203/rs.3.rs-20221/v1 ◽

2020 ◽

Author(s):

Ali Ssetaala ◽

Joan Nabawanuka ◽

Gideon Matovu ◽

Nusula Nakiragga ◽

Judith Namugga ◽

...

Keyword(s):

Antenatal Care ◽

Lake Victoria ◽

Open Data ◽

Fishing Communities ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Need To Evaluate ◽

Development Goals ◽

Victoria Island ◽

Open Data Kit

Abstract Background: Uganda has one of the highest maternal deaths at a ratio of 336 per 100,000 live births. As Uganda strives to achieve sustainable development goals, components of antenatal care are key to reduction of maternal mortality. We explored women’s receipt of seven of the Uganda guidelines components of antenatal care, and associated factors in hard to reach Lake Victoria island fishing communities of Kalangala district.Methods: A cross sectional survey among 486 consenting women aged 15-49 years, who were pregnant or had a birth or abortion in the past 6 months was conducted in 6 island fishing communities of Kalangala district, Uganda, during January-May 2018. Interviewer administered questionnaires, in Open Data Kit software were used to collect data on socio-demographics and receipt of seven of the Uganda guidelines components of antenatal care. Regression modeling was used to determine factors associated with receipt of all seven components. Analyses were done using STATA version 15.1.Results: Women’s median (range) age was 26 (15-45) years, majority were married [87.0%, (423/486)], their main occupation was housewives (stay home mums) [45.1%, (219/486)] and never studied beyond seven years of education [69.1%, (336/486)]. Over three quarters of women who attended the nationally recommended four focused ANC visits did not receive all seven components of care at least once during the visits [76.4%, (107/140), P<0.05]. Women who reported being attended to by a doctor were thrice as likely to have received all seven components as those seen by a midwife/nurse (aOR=3.2; 95% CI:1.1-9.1).Conclusions: There is need to improve components of antenatal care received by women in these communities. Implementation programs need to evaluate receipt of antenatal care components among attendees in these hard to reach communities.Trial Registration: PACTR201903906459874 (Retrospectively registered).

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PO 8550 NATURE AND PREVALENCE OF MULTI-MORBIDITY IN FISHING COMMUNITIES ON LAKE VICTORIA, KENYA

BMJ Global Health ◽

10.1136/bmjgh-2019-edc.137 ◽

2019 ◽

Vol 4 (Suppl 3) ◽

pp. A52.2-A52 ◽

Cited By ~ 1

Author(s):

Zachary Kwena ◽

Raphael Ondondo ◽

Catherine Makokha ◽

Elizabeth Bukusi

Keyword(s):

Diabetes Mellitus ◽

Blood Pressure ◽

Chronic Conditions ◽

Lake Victoria ◽

Sub Saharan Africa ◽

Fishing Communities ◽

Cross Sectional Survey ◽

Chi Square ◽

Cross Sectional ◽

Associated Risk Factors

IntroductionMultimorbidity, coexistence of two or more chronic conditions, is becoming more common across different demographic groups in sub-Saharan Africa. We investigate the nature and prevalence of multimorbidity in fishing communities on Lake Victoria in Kenya.MethodsWe conducted a cross-sectional survey enrolling 679participants in the fishing communities to establish theprevalence of HIV and non-communicable diseases (NCDs)and associated risk factors. The NCDs targeted included diabetes mellitus detected by random blood glucose (RBG) and kidney dysfuction detected by serum creatinine level and proteniuria. Hypertension was defined as systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg. Diabetes mellitus was defined as RBG >7.8 mmol/L and renal dysfunction was defined as estimated glomerular filtration rate (eGFR) <60 mL/min or proteinuria. HIV was tested using rapid Determine assays and reactive results confirmed with UniGold assays. Additionally, participants were determined as having the condition if they reported being on medication for the condition. We analysed the results using descriptive statistics and used Chi-square test to discern if there were statistically significant differences by gender.ResultsOverall, HIV prevalence was 36% while 15%, 12% and 8% of the participants were suspected to have kidney dysfuction, hypertension and diabetes mellitus, respectively. Overall, 12% of the participants had multimorbidity. The most common multimorbidity among those with any of the four chronic conditions was HIV and kidney dysfunction (29%), followed by hypertension and kidney dysfuction (22%), HIV and hypertension (20%), HIV and diabetes (18%), diabetes and kidney disease (6%) and, lastly, diabetes and hypertension (5%). Apart from HIV, we observed no statistically significant gender differences for any of the NCDs or various multimorbidity conditions.ConclusionThese fishing communities have a high burden of both HIV and NCDs resulting in high prevalence of different multimorbidities.

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