Background: The necessity for infection control in health care facilities is a result of the recognized need to prevent Health care associated infections (HCAIs) not only among patients but also among health care workers. This is because of the predisposition to occupational exposure to a number of infections substances while in the line of duty. Occupational exposure to blood can result from percutaneous (needle stick or other sharps injury) and mucocutaneous injury (splash of blood or other body fluids into the eyes, nose, or mouth), or blood contact with non-intact skin. This therefore calls for utmost compliance to Standard Infection control precautions. Compliance with these standard precautions has been shown to reduce the risk of exposure to blood and body fluids. Objective: The purpose of this study was to assess the determinants of compliance to standard infection control precautions among health care workers at Busia health center IV – Busia municipality, Busia District. Method: The study adopted a health facility based cross-sectional design. The study was carried out in Busia Municipality, Busia district. Busia health center IV was purposively sampled. At the health center, consecutive sampling was used to sample the respondents (health workers). Data was collected through structured interviews by the researcher and the research assistants. A structured questionnaire with closed ended and a few open-ended questions were used to collect the data. The data from the completed questionnaires was cleaned, re-coded and entered into the computer using the statistical package for social sciences (SPSS) version 20 Windows for analysis. Results: It was found that the majority of the respondents were compliant to standard infection control precautions (n = 24, (60%). Of the health worker related characteristics; the duration of working as health care personnel was the only one which has a statistically significant relationship with compliance to standard infection control precautions (X2 = 7.839, P = 0.025). Of the health facility related characteristics; the provision of staff with training in occupational health and safety issues, such as safe patient-handling techniques was the only one which has a statistically significant relationship with compliance to standard infection control precautions (X2 = 10.940, P = 0.001). Conclusion: Compliance to standard infection control precautions among health workers at Busia health center IV is moderate, with 6 out of every 10 health workers being compliant. Health worker characteristics and health facility factors determine this level of compliance in equal measure.

The major objective of the study was to establish the role of partner involvement in HIV sero status disclosure among women receiving EMTCT services at TASO Mulago. The specific objectives of the study were; to determine the proportion of women receiving EMTCT services at TASO Mulago who had disclosed their HIV sero status to their sexual partners, to assess the sexual partner factors that influenced HIV sero status disclosure, to establish the relationship between male partner factors that influence disclosure and to assess other factors that influence HIV sero status disclosure among women receiving EMTCT services. Methodology This study was carried out at TASO Mulago in September 2014 on 230 women receiving EMTCT. The study adopted a descriptive cross sectional study design and both primary and secondary data sources were used. Primary data was collected using a focus group discussion with HIV positive women and researcher-administered questionnaires which were given to the women seeking PMTCT services at TASO Mulago. Chi-square test to determine the presence of statistically significant associations (p<0.05) Conclusions The proportion of women receiving EMTCT services who had ever disclosed their HIV sero status to their sexual partners/spouses was low. Women‟s sero status disclosure was found to depend on the woman‟s sexual partner‟s current health status; period spent under HIV treatment as well partner support. Other factors such as marital status and education level were found not to determine whether or not a woman disclosed her sero status. Intervening factors such as counseling and family support were found to play a vital role in sero status disclosure. Recommendations Routine counseling on sero status disclosure should be emphasized by all health facilities offering ART treatment services so that it can be scaled up. All HIV programs should put more emphasis on involving women‟s sexual partners before, during and after HIV testing because this could help ease the difficulties women face in disclosing their sero status to their partners especially when found sero positive.

Background An obstetric fistula is an opening between the vagina and the urinary tract (ureter, urethra, and bladder) or the rectum through which urine and feaces leak continuously. Each year an estimated 15 million women are affected with a chronic morbidity due to child birth, one of the most severe forms is obstetric fistula. Objective The aim of the study was to assess the level of knowledge, attitude and practice of women regarding prevention of obstetric fistula at Kabale Regional Referral Hospital Method: A descriptive cross sectional study employing quantitative method was employed to assess the level of knowledge, attitude and practice of women regarding prevention of obstetric fistula at Kabale Regional Referral Hospital. A total of 322 women from the hospital were included in this study using probability, simple random sampling technique. A structured questionnaire was used to collect data. Data were entered and analyzed using SPSS version 17. Result From the assessment done 66.5% of respondents reported having not heard of obstetric fistula, only 25% of the respondents gave the correct definition as an abnormal passage between epithelial surfaces, usually connecting the cavity of one organ to another or a cavity with the surface of the body, only 27.3% said they knew the signs and symptoms, 34.8% of the women agreed that an obstetric fistula is God’s plan, 65.5% agreed that campaigns against fistula should be public, 54.0% agreed that witchcraft is a risk factor of obstetric fistula and 58.7% did not know if obstetric is preventable with 41.3% think obstetric fistula can be prevented by health facility delivery and antenatal attendance with following health workers instructions; the main preventive measures mentioned by most respondents at 78.2% and 75.2% respectively. Conclusion There was general poor knowledge and attitude as well as practices of the mothers as far as obstetric is concern. Hence, providing knowledge can change the community beliefs and the practices on prevention of obstetric fistula therefore, the researchers recommend increased level of the sensitization throughout the country in different languages to enhance knowledge on obstetric fistula and related topics.

Introduction and Background- Immunization is the process whereby a person is made immune or resistant to an infectious disease, typically by the administration of a vaccine (WHO, April 2014). Globally immunization coverage as measured by proportion of children who have received DPT3 has been increasing from 74% in 2007 to 85% in 2010. It should be noted that the high immunization coverage should not be taken that all children have been immunized and yet so many children continue to miss their DPT3 in Africa (Mbabazi et al 2013). However the factors influencing the existing declining trend of immunisation coverage in Nwoya district are not well understood. The Main Objective- The study investigated the factors influencing immunisation coverage among children under 5 years in Nwoya district and suggested relevant recommendations for mitigation. Methods- A descriptive cross-sectional study was done by the researcher using both quantitative and qualitative method. The investigation was done among all health workers and community vaccinators in government health facility in Nwoya district. The data was collected using questionnaires to collect quantitative data from 162 health workers and community vaccinators in Nwoya district. Qualitative data was also collected using a Focus Group Discussion guide by conducting 6 FGDs of community leaders and VHTs in Nwoya district. The quantitative data was analyzed using SPSS, Epida 3.2 and Microsoft office excel and presented the findings in pie charts and tables. The qualitative data was manually analyzed and presented in quotations and verbatim. The research objectives were address through interpretation of quantitative and qualitative data according to the research objectives. The result- The finding from the study indicates that the major factors that specifically influence immunisation coverage among children under 5 in Nwoya district include the following: 6.2.1: Health workers factors The following health workers factors were found to have a significant influence on immunisation coverage among children under 5 years in Nwoya district are: level of qualification of the health workers (P-value<0.008),duration of qualification of the health workers(P-value<0.043),receiving of allowances for immunisation outreach activities(P-value<0.001 6.2.2: Health system factors The study also revealed the following health system factors that significantly influenced the immunisation coverage in Nwoya district: The number of outrearches per month(P-value<0.016), The availability of vaccines at health facility (P-value<0.001), and the availability of transport for immunisation activities (P-value<0.001 6.2.3 Community factors The key community factors that were found to have a significant influence on immunisation coverage was the level of mobilization of the community for immunisation (P-value<0.002).

Introduction: Also known as Infant oral mutilation (IOM), false teeth removal is a traditional method of extracting an infant‟s un-erupted teeth as a cure for medical symptoms in infants that include high fevers, diarrhoea and vomiting. It is practiced in several Sub-Saharan African countries, including Uganda. Objectives: The study particularly sought to determine the prevalence and factors associated with false teeth removal( Infant Oral Mutilation) among children under five years in Bungatira Sub county, Gulu District. Method: This cross sectional study was conducted in Bungatira Sub-county in Gulu district, involving 150 participants with children less than five years that voluntarily accepted and signed a consent form. The respondents were selected using simple random sampling from accessible population; and data analyzed using descriptive statistics and bi-variate method as well as SPSS and Microsoft Excel presented in figures and tables. Result: The prevalence of infant oral mutilation was high at 78%, and the socio-demographic factors such as the age and sex of the child, and care-takers‟ socio-demographic factors like gender and level of education had no significant association with the prevalence of false teeth removal among the children below five years. However, other socio-demographic factors of the care-takers such as age, marital status, employment status/occupation, religion and relationship to the child had a significant influence on the prevalence of false teeth removal of the children. It was observed that false teeth removal was higher among the care-takers with a lower level of education, lower socio-economic/employment status and those with a biological parent relationship to the child than those with a higher level of education, higher socio-economic/employment status and those who were guardians and not biological parents to the children. In regards to knowledge factors, the majority of people had ever heard about false teeth, and their main source of information was their parents, with ancestral/ancestral roots as the main reason for infant oral mutilation. Conclusion/recommendations: The high prevalence of infant oral mutilation has been greatly influenced by the gap in the caregivers‟ knowledge factors which included their awareness, reasons for infant oral mutilation and major sources of information about this traditional practice. Therefore, this study recommends that there is need to revive community sensitization. However, these programmes of community health workers will need to include appropriate cultural educational materials targeting parents and local healers/traditional birth attendants since these play a key role in fuelling the removal of children‟s false teeth. Keywords: Infant Oral Mutilation; Children under five; Caretakers; Uganda

Title: Assessing factors influencing utilization of antenatal services among adolescents in Pajule health center IV: Pader district Background: Antenatal care is a key strategy for reducing maternal mortality but many pregnant adolescents in Pader district do not receive it. Aim: The purpose of this study was to assess and analyze the main factors affecting the utilization of antenatal care among the pregnant adolescents of Pajule health center IV: Pader district. Methodology: Raw data collected from Pajule health center from pregnant adolescents 13-19 years of age using simple random sampling method was used. From the large dataset of women, a total of 300 teenage women at the time of their attendance at the post natal clinic were selected and analyzed. Both bivariate and multivariate analyses were performed to determine the differentials of ANC by explanatory variables. Results: Findings generated by the descriptive analysis of the total 300 respondents revealed that the socio-demographic factors and personal factors were significantly associated to uptake of ANC by the pregnant adolescents while there was no significant relationship between health systems factors and uptake of ANC by the pregnant adolescents. Conclusion: More qualitative and quantitative research is required to explore the factors influencing ANC utilization among pregnant adolescents with more emphasis on socio-demographic and personal factors. Adequate utilization of antenatal care cannot be achieved merely by establishing good health systems factors in place, adolescent’s overall (social, political and economic) status needs to other factors should be considered.

Background: Latrines are facilities that are normally constructed at the household levels for the purpose of safe excreta disposal. Poor latrine coverage and usage at household level in any given community can leads to greater risks of spreading the feaco-oral diseases through water, soil and food contaminations. The major objective of the study research is to assess the factors influencing the availability and utilization of the household latrines in Puranga sub-county, Pader district in northern Uganda. Methodology: A cross sectional study composed of 387 households was done in Puranga sub-county. The sub-county was stratified in to six Parishes and in each parishes, villages were selected using simple random sampling. In each village selected, a complete list of households were obtained and all these households were numbered . The first household for data collection (refers to as the reference) was also selected by simple random sampling using table of random numbers. Data collection then started immediately from the household which was much closed to the reference household. . This procedure was used until the required sample size were reached in a given village. Data collection was done using standard questioners, observation checklists, key informant interviews to health workers and focus group discussions. Pre-testing of the tools was done before the actual data collection started and Data analysis was performed using SPSS version 16. Main findings: 1. Household latrine availability and usage In this study, households with functional pit latrine were 206 (53%). Out of this functional pit latrines, 159 (38.7%) are owned by the individual households and 56 (14.4%) are owned by the landlords. The major type of pit latrine in the area is traditional pit latrines 176 (545.5%), followed by VIP pit latrines (4.4%). 2. Quality of the household pit latrines in use Of the latrines found in the households, 156 (75.7%) are properly sited on a well drained ground, 45(21.8%) are in the standard distance of 10 meters away from the main building, 172 (83.4%) are made up of temporary materials, 24 (11.6%) are made up of semi permanent and 6 (2.9%) are made up of permanent materials. 3. Socio-economic information 323 (83%) of the house hold members were settled on their own land. The analysis of the chi-square showed that there is a significance in owning land and the availability and usage of household latrines in the sub-county (chi- square = 184.209; P-value = 0.0005). and 287 (74%) of the respondents have ever attended school. The analysis of this result shows that, there is a significance in the education status and latrine availability and usage in Puranga sub-county (chi- square = 80.953; P-value = 0.0002). Only 15(3.9%) of the household reported that there are cultural practices affecting the availability and usage of latrines in the area. Among them were children feaces should not be mixed with adults 9 (2.3%) and that use of latrine can sometimes involves the use of ashes on feaces which is a taboo 6(1.5%) 4. Scale up efforts for latrine availability and usage 235 (60.7%) households received health education on latrine use, while 215(55.5%) of the households had attended meeting on latrine availability and usage. The chi-square analysis of this result showed that there is a significance in attending community meeting on latrine and possessing and using household latrine (chi- square = 4.344; P-value = 0.037). The availability and usage of the household latrines were much higher among the household who have knowledge on pit latrine 192(49.6%), followed by those household that are settled on their own land 187(48.3%), those who went to school 148(38.2%), those who attended the community meetings on latrines 131(33.8%) and those who are aware of the existence of the bye-laws 109 (28%). Conclusion: The latrine coverage of Puranga sub-county is 53% which is slightly higher than the one for the overall district 46%. However it is still lower than the national target of 77%. The major factors that are affecting the availability and usage of pit latrine at house hold level includes Inadequate political support on household latrine use, low level of education of the household members, poverty, limited visits to house holds by health workers to inspect homes, no prioritization of the household latrine as one of the necessity, lack of skills on latrine construction and negligence of some local communities. Recommendations: The sub-county authorities should organize home improvement campaign in order to raise the level and use of latrine at home, Advocacy meeting on household sanitation should be done to political leaders in the sub-county, Health workers should start regularly inspecting home for hygiene and sanitation standard, train more household member on how to construct latrine at home including the various latrine options and the sub-county authority should disseminate and implement the bye –laws created in the sub-county to all the lower levels.

Introduction In Uganda male involvement in ANC is generally low averaging 3% in 2006, MoH. This remains a challenge to safe motherhood since about 210 million women become pregnant each year with 30 million developing complications which result in over a half a million maternal deaths. Antenatal care is defined as the care given to a pregnant woman to ensure early detection and treatment of pregnancy related complications as well as providing education and information about pregnancy, child birth and peuperium in order to improve her health and that of the baby. For this to be effective their spouses need to be brought on board so that they give them the necessary support. Objective The objective of the study was to determine the factors influencing male participation in attendance of Antenatal care in Makindye division, Kampala Capital City Authority Methodology This was a cross sectional study employing both quantitative and qualitative techniques. A total of 384 expectant mothers attending ANC at the health facilities in Makindye division were randomly selected to participate in the study and 10 Key Informants were interviewed. Data was collected using semi structured questionnaires and Key informant interview guides. The quantitave data was then analyzed a computer Statistical Package for Social Scientist (SPSS version 16) at univariate, bivariate and multivariate levels of analysis and presented in a meaningful form using tables of frequencies, percentages and charts. Qualitative data was analyzed using thematic analysis. Results The results of the study indicated that 98(26%) of the men in Makindye division accompanied their spouses to the health facility for ANC. Factors that were associated influenced male participation in ANC attendance included; couples living together (pv=0.000) those who had 1-2 (0.001) children and those who had attained a high level of education (pv=0.002), among the individual factors. Those who were in polygamous relationships (0.002) and those who worked in sales and services (0.000) were the socio-economic factors that influence male participation in ANC attendance. While those who travelled a distance of less than 5km (0.002) and those who were recognized as a couple at the health facility (0.005). Conclusion In conclusion, the study revealed low male participation in ANC attendance of and limited knowledge of the respondents about importance of ANC in Makindye division. The outstanding barriers to male participation in ANC included men failing to get time off their busy work schedules and long waiting time. Strategies for improving male participation should include, empowering men and women with knowledge about ANC, formation of fathers‟ clubs at ANC, incorporate services for men alongside ANC like safe male circumcision and having policies that allow men with expectant partners time off work so as they accompany their spouses for ANC so as to promote male participation in ANC attendance.

Introduction: Nurses and midwives are the backbone of health service delivery worldwide. Due to the critical position they hold in the health sector, emphasis is put on the quality of their training and competences during their preparation for effective service delivery (Barksdale, Newhouse, & Miller, 2014; Ministry of Health Uganda, 2012; WHO, 2016). Therefore a study on the factors influencing the involvement of preceptors in clinical teaching of student nurses in training hospitals in Masaka Referral and Kitovu Hospitals in Masaka district in August 2018 was carried out. Methods: The study employed a descriptive and cross sectional study using quantitative method of data collection. A sample size of 98 respondents who were nurses and midwives was used. Respondents were selected by purposively and simple random sampling methods. Data was collected using a questionnaire. Results: Multivariate analysis of factors influencing the involvement of preceptors in clinical teaching of student nurses in training hospitals in Masaka Referral Hospital and Kitovu Hospital that were significantly associated with involvement of preceptors in clinical teaching were education level (P=0.001), Religion (P=0.023), work experience (P=0.023), were supposed to be given money to teach student nurses at clinical area (P=0.001), belief nursing students respect Registered Nurses as practitioners (P=0.001), Registered Nurses consider nursing students as part of the nursing team (P=0.000), Would spend extra time with student nurses, even if the instructor would supervise them (P=0.005), Number of patients usually on ward/unit per day (P=0.000) and Number of student nurses usually on ward (P=0.000). Conclusion: Results showed low preceptor involvement in clinical teaching at 41 (41.9%). This was mostly associated to personal factors mainly inadequate skills and negative attitude of the preceptors towards clinical teaching probably due to low motivation. Recommendations: More nurses and midwives should be recruited to reduce the preceptor student ration and also be given on the job training to improve their skills.

The one month internships at ART clinic Juba military hospital was organized on major public health issues such as VCT, adherence counseling on HIV/AIDS positive living, health education and health promotion, data collection and even ART pharmacy. However, there were some major challenges that I have faced while at ART clinic Juba Military Hospital. I.e. language, transport and insufficiency health facilities among other challenges thought I have propose some recommendation such as increase in health care facilities, patient’s follow up while on HIV/AIDS medication and generally transport for easy accessibility of workers to all the SPLA sub-unity.