Browsing by Author "Epuitai, Joshua"

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    “I don’t support It for my children”: perceptions of parents and guardians regarding the use of modern contraceptives by adolescents in Arua City, Uganda
    (Hindawi, 2023-04-03) Vuamaiku, Godfrey Jalinga; Epuitai, Joshua; Andru, Monicah; Aleni, Mary
    Despite the high rates of adolescent pregnancies, the utilization of modern contraceptives is still low among adolescents in Uganda which highlights a missed opportunity for the prevention of unwanted pregnancies among adolescents. We explored the perception of parents and guardians regarding the use of modern contraceptives by adolescents and the roles parents and guardians play in the use of modern contraceptives by the adolescents. A descriptive qualitative study was conducted in one of the suburbs of Arua city in the West Nile subregion in Uganda. Fifteen (15) in-depth interviews were conducted with parents and or guardians to explore their perceptions and roles regarding the use of modern contraceptives by adolescents. Thematic analysis was used in qualitative data analysis. Parents did not support adolescents’ use of modern contraceptives. Lack of parental support was related to perceptions that modern contraceptives promote sexual promiscuity, fear that it causes infertility and that it is incompatible with cultural, religious, and moral norms. Parents and guardians opted to emphasize the importance of abstinence, conformity with cultural and religious norms, and the need to focus on completing school instead of encouraging the use of modern contraceptives. Few parents and guardians supported the use of modern contraceptives, specifically condoms, to prevent unwanted pregnancy by the adolescents and parents/guardians, sexually transmitted infections, and early school dropouts. Parents and guardians expressed feelings of inadequacy related to discussions on contraception use with their adolescent children and therefore avoided talking about it. Our study reveals a lack of parental support regarding the use of modern contraceptives among adolescents. Public health interventions which promote intergenerational, socioculturally, and religiously appropriate communication should be instituted in the communities in order to promote sustainable adoption of modern contraceptive use among adolescents.
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    Prevalence and factors associated with neonatal hypothermia: a cross-sectional study among healthy term neonates in a peri-urban hospital in Northern Ugand
    (Springer Nature, 2025-10-08) Akao, Mary Grace; Nalwadda, Gorrette; Epuitai, Joshua; Ayebare, Elizabeth; Ndeezi, Grace; Ratib, Dricile; Tumwine, James K
    Background Neonatal hypothermia is highly prevalent even in warm tropical countries. Neonatal hypothermia increases the risk of morbidity and mortality. In Uganda, the prevalence of hypothermia is not known among healthy term neonates. Objective To determine the prevalence of neonatal hypothermia and the associated factors in Lira Regional Referral Hospital. Methods Hospital-based cross-sectional study was conducted in Northern Uganda. The interviewer-administered questionnaires and direct observations used to determine the initiation of warm-chain practices after delivery for 271 newborns. The axillary temperature of neonates was measured at intervals of 10 min, 30 min, one hour, and 2 h after birth. The multivariate binary logistic regression was done. The 95% confidence interval (CI) and p-value < 0.05 used to identify factors significantly associated with neonatal hypothermia. Results Neonatal hypothermia was 67.6% during the first two hours postnatal. Neonatal hypothermia was 64.5% at 10 min, 81% at 30 min, 76% at one hour and 49% at two hours postnatal. Hypothermia was significantly associated with low birth weight (Adjusted odds ratio (AOR) = 2.78; 95% CI: 1.01–7.62); male sex (AOR = 1.69; 95% CI: 1.04–3.33), not drying the newborn (AOR = 3.06, 95% CI: 1.64–5.72); no skin to skin contact within five minutes postnatal (AOR = 2.17, 95% CI: 1.15–4.10); and low maternal body temperature (AOR = 2.70, 95% CI: 1.49–4.76). Conclusions The prevalence of neonatal hypothermia was high in the first two hours. Neonates who were more likely to have hypothermia were male, not dried properly, low birth weight, no skin-to-skin contacts, and low maternal body temperature. Proper drying of the newborn and skin-to-skin contact can reduce the burden of neonatal hypothermia. There is a need to train the midwives on proper drying of the newborn, keeping the mother warm, and the importance of skin-to-skin contact in prevention of neonatal hypothermia among male and low birth neonates.
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    The perceived impact of a student-led domiciliary midwifery care on patient-centered care: A mixed methods inquiry into postnatal mothers’ experiences
    (Elsevier, 2026-02-09) Aleni, Mary; Epuitai, Joshua; Akao, Mary Grace; Ayiasi, Richard Mangwi; Assusi, Mildred Edna; Andru, Monicah; Otim, Douglas Tonny; Kakyo, Tracy Alexis
    Background Domiciliary midwifery care focuses on providing pregnancy, labor, and postpartum care in women’s homes rather than in health facilities, yet this model of care remains underexplored in Uganda. Purpose To examine the experiences of postnatal mothers with a student-led domiciliary midwifery care and its influence on patient-centered care. Materials and Methods We conducted a sequential explanatory mixed-methods design among postnatal mothers who had received student-led domiciliary midwifery care. Quantitative data were collected using a patient-centered care (PCC) scale, while qualitative data were collected using in-depth interview. Qualitative data were analyzed using content analysis based on the PCC constructs, while quantitative data were summarized using descriptive statistics. Results Mothers experienced moderate levels of PCC after completing the student-led domiciliary midwifery care (Mean 3.46 ± 0.704) and were satisfied with the care provided (Mean 4.19 ± 0.804). Respect for patients’ preferences, values, and needs scored highest among the PCC constructs (Mean 4.03 ± 0.94), whereas continuity and transition of care scored lowest (Mean 2.92 ± 1.06). Client’s experience of domiciliary care was shaped by skepticism toward new model of care, the familiarity of home setting versus hospital settings, and care provided by male students. Conclusion Student-led domiciliary midwifery care had a moderate effect on PCC, with most postnatal women satisfied with the care. The Findings highlight the need to raise community awareness about domiciliary midwifery and the importance of integrating mothers’ experiences into curriculum design.
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    Trauma led us to substance use: an interpretative phenomenological analysis of refugee youth experiences with substance use during the COVID-19 pandemic in Uganda
    (BMJ Publishing, 2026-02-05) Akello, Sarah Racheal; Epuitai, Joshua; Ayiasi, Richard Mangwi; Kakyo, Tracy Alexis
    Introduction: Refugee populations experience significant psychological stress in host countries. The COVID-19 pandemic worsened pre-existing vulnerabilities and also presented new vulnerabilities for substance use. The study was conducted to examine the pattern of substance use during and after the COVID-19 pandemic among youth residing in a rural refugee settlement camp in north-western Uganda. Methods: The study was conducted in a refugee settlement camp in north-western Uganda. We used an interpretative phenomenological analysis framework to explore substance use among young people. We conducted eight in-depth interviews and four focus group discussions among youths between the ages of 18–30 years. Results: We identified two master themes: (1) trauma led us to substance use and (2) desire for belonging and identity kept us in substance use. Young people recounted stories of trauma which served to initiate and promote substance use among them. COVID-19 restrictions on social isolation, social distancing and military enforcement of the restrictions exacerbated previous experiences of trauma resulting in substance use. Refugees, who were already separated from their families in the host country, engaged in substance use following further parental and social isolation, loneliness and reduced support systems in refugee camps. The reduced financial support, unemployment, closure of businesses and schools provided additional motivation to engage in substance use among young people. Surviving the refugee camp heightened the need for belonging to a group. The desire to belong in, to fit in and to stand out in the group altogether served to provide further avenues for substance use among young refugee populations. Conclusion: Interventions for substance use among refugee youth, particularly during a pandemic, ought to consider the complex landscapes for refugees and their multiple layers of vulnerabilities. Peer pressures and group influence should be given special considerations while planning mitigation measures.