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Geographic location of health facility and immunization program performance in Hoima district, western Uganda: a health facility level assessment.

ABSTRACT: BACKGROUND:Globally, immunization coverage for childhood vaccines is below the immunization target of achieving at least 90% coverage with the pentavalent vaccine. In Uganda, a recent survey shows 80% of districts had poor immunization program performance. However, there is significant variation in performance within and between districts. We hypothesized that geographic location of a health facility may influence performance of its immunization programs. Therefore, the purpose of this study was to examine whether geographical location of a health facility within a district is associated with performance of the immunization program in Hoima district, western Uganda. METHODS:We conducted a cross sectional study using a mixed methods approach. The main study unit was a health center and we also interviewed health workers in-charge of the facilities and reviewed their health facility records. We reviewed the Uganda Health Management Information System (HMIS) 105 reports of six months to obtain data on immunization program performance. Performance was categorized using World Health Organization's Reach Every District (RED) criteria and classified as poor if a facility fell in category 3 or 4 and good if 1 or 2. We also conducted key informant interviews with immunization focal persons in the district. We examined the association between dependent and independent variables using Fisher's exact test. RESULTS:We collected data at 49 health facilities. Most of these facilities (55.1%) had poor immunization program performance. Proximal location to the central district headquarters was significantly associated with poor immunization program performance (p?

SUBMITTER: Magambo NK

PROVIDER: S-EPMC7686762 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

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Geographic location of health facility and immunization program performance in Hoima district, western Uganda: a health facility level assessment.

Magambo Nicholas Kwikiriza NK Bajunirwe Francis F Bagenda Fred F

BMC public health 20201123 1

<h4>Background</h4>Globally, immunization coverage for childhood vaccines is below the immunization target of achieving at least 90% coverage with the pentavalent vaccine. In Uganda, a recent survey shows 80% of districts had poor immunization program performance. However, there is significant variation in performance within and between districts. We hypothesized that geographic location of a health facility may influence performance of its immunization programs. Therefore, the purpose of this s ...[more]

PMID: 33228669

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Project description:Over 80% of morbidity due to soil-transmitted helminthiasis (STH) occurs in low-income countries. Children under 5 account for 20-30% of the burden in endemic areas. This study assessed the prevalence, intensity and factors associated with STH infections among preschool-age children (PSAC) in Hoima district, Uganda. The PSAC are particularly vulnerable because the chronicity of this condition usually affects their physical and mental growth and development.A cross-sectional study was carried out among 562 PSAC (1-5 years old) in 6 counties of Hoima district using Expanded Program on Immunization (EPI) method. Stool samples from children were examined using the formol ether concentration technique for STH egg detection. Egg counts were represented as egg per gram (EPG). A structured questionnaire was used to collect information on factors associated with STH infection. Generalized linear models were used to analyze relationships between STH infection and associated factors.Overall STH prevalence was 26.5%. Hookworm infection was the most prevalent (18.5%), followed by A.lumbricoides (9.8%) and T.trichiura (0.5%). Prevalence of STH infection was significantly higher in children aged 5 years (Pearson chi-square test, p?=?0.009) than in children aged 1 year. The general geometric mean (GM) counts for Hookworm infection was (696.1 EPG; range (530.3-913.8)) with girls having a higher GM (789.8 EPG; range (120-13,200)) than boys. Eating uncooked or unwashed vegetables (adj. Prevalence Ratio (PR)?=?1.9, 95% CI: 1.3-2.7) and fruits (adj.PR?=?1.8, 95% CI: 1.1-2.8), indiscriminate disposal of young children's faeces (adj.PR?=?1.5, 95% CI: 1.1-2.0); not washing hands after defecation (adj.PR?=?2.6, 95% CI: 1.9-3.6); and not deworming children regularly (adj.PR?=?1.4, 95% CI: 1.1-1.8) were significantly associated with STH infection.The prevalence of Soil transmitted helminths infection among preschool-age children in Hoima district significantly increased with age. Poor hygiene, inadequate sanitation and irregular deworming were associated with STH infections among PSAC in the study area. Intense health education on the importance of hygienic practices, improved sanitation and regular deworming of PSAC should be integrated into prevention and control programs.

Project description:Background Oral health promotion (OHP) during pregnancy is an important global public health and basic human right issue related to quality of life. Several statements and guidelines have been published emphasizing the need for improved oral health care of pregnant mothers, prenatal care providers have missed this critical opportunity. In this study, we assessed factors influencing adoption of oral health promotion by antenatal care providers. Materials and methods A descriptive cross-sectional study design that employed both quantitative and qualitative data collection methods and analysis. 152 samples determined using Yamane’s 1967 and stratified sampling technique was used. Three FGDs and six KI interviews were held. Univariate, bivariate and multivariate analyses were done using SPSS (20.0) and ATLAS Ti for qualitative analysis. Results Adoption of OHP was low 28% (42). Factors influencing adoption were age of respondents (OR = 0.066, 95%CI = 0.009–0.465, p = 0.006*), level of care of health facility (OR = 0.050, 95%CI = 0.008–0.322, p = 0.002*), good understanding between dentists and ANC providers (OR = 0.283, 95%CI = 0.084–0.958, p = 0.042*), availability of practice guideline for OHP in ANC (OR = 0.323, 95%CI = 0.108–0.958, p = 0.043*), number of years at work (p = 0.084), being knowledgeable (OR = 2.143, 95%CI = 0.864–5.311, p = 0.100), having skills to advance OHP(OR = 0.734, 95%CI = 0.272–1.984, p = 0.542), Management being good at influencing new practices (OR = 00.477.734, 95%CI = 0.227–2.000, p = 0.477). More emphasis on national and local of oral health issues, continuous staff training on oral health, dissemination of National oral health policy (NOHP) were some of key issues that emerged from the qualitative results. Conclusion Adoption of OHP was low. This was attributed to age, number of years spent at work, level of health facility, having good understanding between dentists and ANC providers, availability of practice guidelines, dissemination of National oral health policy, continuous staff training. We recommend the current NOHP to be reviewed, develop prenatal OHC guidelines, enhance the capacity of ANC providers through training, collaboration with dentists and launch official adoption of OHP.

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Geographic location of health facility and immunization program performance in Hoima district, western Uganda: a health facility level assessment.

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Geographic location of health facility and immunization program performance in Hoima district, western Uganda: a health facility level assessment.

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