94 research outputs found
Exploring the health and wellbeing of adolescents living with HIV as they grow into adulthood : unique challenges in a low resource setting
No full textAbstract: Advances in early infant diagnosis of HIV infection in HIV exposed children and the increased availability and access to pediatric HIV treatment have reduced the mortality and morbidity of children born with HIV, resulting into more children surviving into adolescence. Eighty percent of all adolescents living with HIV (ALHIV) globally live in sub Saharan Africa. Uganda, like many resource limited countries has made significant strides in the fight against HIV/AIDS. The rapid scale up of anti-retroviral therapy (ART) in this country has decreased the morbidity and mortality of ALHIV. As these ALHIV mature and their life expectancy increases, they face several challenges ranging from adhering to long term ART and negotiating through various situations and relationships to survive into adulthood. While the majority of available studies including ALHIV focus on their medical treatment, this thesis aims to go beyond the treatment response as such. The thesis describes not only the response of ART on the growth and development of perinatally infected adolescents, but puts emphasis on the exploration of the psychosocial challenges ALHIV face as they grow up and their lives become normalized. This includes also describing the sexual and reproductive health needs and sexual activity among ALHIV. This thesis adds a comprehensive description of psychosocial and psychosexual challenges as they manifest in clinical/treatment settings dealing with ALHIV to the available body of knowledge on the needs of ALHIV. Its results therefore are relevant not only from an academic perspective but also for health care providers working in such settings. The findings may contribute to increasing youth-friendly, evidence-based HIV services. This thesis includes studies conducted in Uganda and Kenya which are among the high HIV burden countries. Four studies resulting in five articles highlight three intertwined challenges related to disclosure of HIV status, treatment adherence and prevention of HIV transmission. Based on our study findings, strategies to improve the health and wellbeing of ALHIV in resource limited settings are proposed. In the first study, adolescents with predominantly perinatally-acquired HIV infection and significant disease burden showed appropriate virological and immunological response to ART in addition to having clinically significant improvements in growth and some improvement in sexual maturation. In the second study, we examined the perceptions of young people living with HIV in Uganda about current norms around HIV serostatus and treatment disclosure. Our findings reinforce the concept of HIV disclosure as a process, not a one-time event. We studied disclosure processes and outcomes. Two studies assessed the sexual and reproductive health behaviors of ALHIV: a qualitative study explored the meaning ALHIV attribute to sexuality and their sexual norms in the light of shaping their sexual and social identities. About a quarter of the young participants reported prior or current sexual experience. The quantitative study demonstrated that early sexual activity remains an important risk factor for HIV transmission and potentially results in negative health consequences including onward transmission of sexually transmitted infections. The two studies revealed knowledge gaps relating to reproductive health, HIV transmission, and contraceptive methods. Motivations for safe preventive sexual behavior included having specific future aspirations, good counseling, and fear of the consequences of sexual activity such as unwanted pregnancies. Barriers to adopting preventive behaviors included personal factors (i.e. alcohol use), interpersonal factors (i.e. ignorance of serostatus of sexual partners, peer pressure), social factors (HIV-related stigma) and poverty as a structural determinant. In addition, desire to have children played an important role for the older ones. Young seropositive people in this setting lacked specific behavioral skills, such as disclosure of HIV status to their sexual partners, which was closely linked to fear of rejection and stigma. This thesis clearly demonstrates that HIV positive adolescents and young people are able to respond well to ART and that they are able to grow; however, as they grow, they may face specific challenges of disclosure and navigation of their sexual maturation. Interventions in this field need to be age appropriate, and based on the psychosocial developmental stage as well as being tailored to young people\u2019s specific needs. Structural interventions should at the same time address and reduce HIV-related stigma and support the socio-economic needs of young people living with HIV. Despite the increased attention and commitment to the pediatric and adolescent HIV agenda, further efforts are required to respond to the glaring gaps. The global AIDS response is at a critical point where the successes of antiretroviral therapy provision is now competing with complacency. The ambitious global targets of ending AIDS are not being realized in a timely manner as expected by the UNAIDS. For instance, there are still nearly a million people dying each year from AIDS-related illnesses and only three out of every four persons living with HIV knows their HIV status. These targets are even less achieved for adolescents and young people who contribute to the highest AIDS-related deaths and the new transmissions. Moreover, there is a limited number of health-care workers specialized in taking care of adolescents and young people. There is also continuing stigma and discrimination and this could result in a prevention crisis. When ALHIV start to engage in sexual activity and are not able to disclose their HIV status to their sexual partners there is an added risk of transmission. This is particularly plausible when they are not adhering well to their treatment and remain virally unsuppressed. For ALHIV, it is critical that the interventions put in place to prevent onward transmission, and maintain their healthy livelihood are geared towards making these interventions reachable to them in an adolescent responsive manner. This can be done through evidence-based interventions and policies that comprehensively address the multiple needs of the ALHIV
The challenges of treating HIV-infected adolescents
No full textAdolescents and young people represent a growing share of people living with HIV worldwide. In 2020 alone, 410,000 [194,000-690,000] young people between the ages of 10 to 24 were newly infected with HIV, of whom 150,000 [44,000-310,000] were adolescents between the ages of 10 and 19. To compound this, most recent data indicate that only 25 per cent of adolescent girls and 17 per cent of adolescent boys aged 15-19 in Eastern and Southern Africa – the region most affected by HIV – have been tested for HIV in the past 12 months and received the result of the last test. The testing rates in West and Central Africa and South Asia are even lower. If current trends continue, hundreds of thousands more will become HIV-positive in the coming years, and without knowing their status, adolescents will miss out on life-saving treatment. Additionally, a large population of children infected with HIV perinatally over the last decade are growing into adolescence
STRATEGIC SOURCING FOR SUSTAINABILITY OF UNIVERSAL HEALTHCARE COVERAGE: A CASE STUDY OF KENYA MEDICAL SUPPLIES AUTHORITY
No full textAbstract: Universal Health Coverage (UHC) means that all people have access to the health services that they need without the risk of financial hardship when paying for them (WHO, 2010). The main objective of this study was to examine the influence of strategic sourcing on the sustainability of universal healthcare coverage by the Kenya Medical Supplies Authority with the following specific objectives of the study; to establish the influence of strategic supplier selection on the sustainability of universal healthcare coverage by Kenya Medical Supplies Authority, to assess the influence of supplier relationship management on the sustainability of universal healthcare coverage by Kenya Medical Supplies Authority, to examine the influence of supplier negotiation on the sustainability of universal healthcare coverage by Kenya Medical Supplies Authority and lastly determine the influence of strategic procurement planning on the sustainability of universal healthcare coverage by Kenya Medical Supplies Authority. The study adopted a cross-sectional survey. The target population of this study was 348, including management staff in Kenya Medical Supplies Authority. A semi- structured questionnaire was administered through the e-mail survey and hand delivery. Secondary data was obtained from both published and unpublished records. The questionnaire was tested for validity and reliability. Both quantitative and qualitative techniques were used to analyze the data with SPSS software program version 25. The study found that both strategic supplier selection, supplier relationship management, supplier negotiation, strategic procurement has a significant influence on the sustainability of universal healthcare coverage by the Kenya Medical Supplies Authority; hence the study recommended that managers in the humanitarian organizations in Kenya Medical Supplies Authority should include strategic sourcing practices in their strategic plan and particular investment in strategic supplier selection, supplier relationship management, supplier negotiation strategic procurement which may make it easy to bring about innovation in the organization and good information sharing to both suppliers and clients
Keywords: strategic supplier selection, supplier relationship management, supplier negotiation, strategic procurement, sustainability.
Title: STRATEGIC SOURCING FOR SUSTAINABILITY OF UNIVERSAL HEALTHCARE COVERAGE: A CASE STUDY OF KENYA MEDICAL SUPPLIES AUTHORITY
Author: Mary Ndunge Kitaka, Dr Jane Queen Omwenga
International Journal of Social Science and Humanities Research
ISSN 2348-3156 (Print), ISSN 2348-3164 (online)
Vol. 10, Issue 2, April 2022 - June 2022
Page No: 241-256
Research Publish Journals
Website: www.researchpublish.com
Published Date: 20-May-2022
DOI: https://doi.org/10.5281/zenodo.6566610
Paper Download Link:
https://www.researchpublish.com/papers/strategic-sourcing-for-sustainability-of-universal-healthcare-coverage-a-case-study-of-kenya-medical-supplies-authorityInternational Journal of Social Science and Humanities Research, ISSN 2348-3156 (Print), ISSN 2348-3164 (online), Research Publish Journals, Website: www.researchpublish.co
Management of Infections and Fever in Sickle Cell Disease (SCD)
No full textSickle cell disease (SCD) is one of the major neglected chronic diseases globally, with increasing incidence in parts of Western and Central Africa. Individuals with SCD are highly susceptible to infections, especially bacterial infections, which are severe and often lead to death. Thus, the management of infections among people with SCD through preventive or curative interventions is imperative. This chapter highlights SCDs, transmission of the disease, clinical manifestations, and strategies for managing infections and fever in individuals with SCDs
No difference in sexual behavior of adolescent girls following Human Papilloma Virus vaccination: a case study two districts in Uganda; Nakasongola and Luwero
No full textIncidence and risk factors for first line anti retroviral treatment failure among Ugandan children attending an urban HIV clinic
No full textPrevalence, clinical pattern and immediate outcomes of HIV-infected children admitted to Al Sabah Children’s Hospital, South Sudan
No full textIntroduction: HIV continues to be a major global health issue. There were approximately 2.1 million infected children aged <15 years in 2017 and most were in sub-Saharan Africa. South Sudan with its low prevention of mother to child transmission (PMTCT) coverage has a greater risk of high transmission rates of HIV from mothers to their children.Objective: To determine the prevalence of HIV infection, the clinical pattern, and the immediate outcomes of children admitted to Al Sabah Children’s Hospital.Method: This was a cross sectional descriptive study, with a longitudinal component for the immediate outcome. A total of 828 children were recruited: 424 aged <18 months and 424 aged ≥ 18 months. HIV rapid tests were done to confirm the HIV infection for children aged ≥18 months, while HIV DNA-PCR was done to confirm the HIV infection for children aged <18 months found to be HIV exposed.Results: Twenty four children tested HIV positive giving an overall HIV prevalence of 2.8% (95% CI 1.8 – 4.2). The clinical characteristics associated with HIV infection were: a history of cough (p=0.001), weight loss (p <0.001), oral thrush (p <0.001), lymphadenopathy (p=0.001), ear discharge (p <0.001), skin lesion (p <0.001), hepatomegaly (p <0.001), and splenomegaly (p <0.01). Factors associated with prolonged hospital stay were history of weight loss (OR=4.96, 95% CI 2.68-9.18), skin lesions (OR=3.60, 95% CI 1.36-9.56), and weight for height/length z score<-3SD (OR=8.67, 95% CI 4.70-15.99).Conclusion: The prevalence of HIV among this hospital based population of children aged less than 15 years was 2.8%. Children who presented with cough, weight loss, oral thrush, lymphadenopathy, ear discharge, skin lesion, hepatomegaly, and splenomegaly in this setting were likely to have HIV infection and should therefore raise suspicion for testing and early diagnosis.Keywords: HIV infection, clinical characteristics, children, hospital stay, South SudanSouth Sudan Medical Journal Vol 12 No 3 August 201
Encouraging improvement in HPV vaccination coverage among adolescent girls in Kampala, Uganda.
No full textIntroductionWHO recommends vaccination against HPV for girls before sexual debut. Uganda started HPV vaccination in 2008 as pilot programs in 2 districts, followed by national roll out in 2015. Despite the availability of vaccines against human papillomavirus (HPV) in Uganda in the period covered by the study, there was reported low HPV vaccine uptake and completion especially of the second dose in Uganda; with little information available on timely completion of HPV vaccine and the associated factors in Uganda. This study was therefore done to determine the HPV vaccine dose 2 completion and describe the possible factors associated with timely HPV vaccine completion and non-completion among girls of age 9-14 years attending the adolescent clinic at Mulago hospital.MethodsA retrospective mixed methods study was conducted in Mulago National Referral hospital adolescent clinic. Data were mainly collected through review of charts and folders for clinic attendance by eligible girls and focus group discussions with eligible girls that completed the 2 doses of HPV vaccine on recommended/scheduled time.ResultsOut of the 201 girls studied, 87 girls (43.3%) had timely completion of the HPV vaccination. Knowledge about HPV infection and HPV vaccine benefits, positive peer influence and healthcare worker recommendation to get vaccinated at health facility level positively influenced timely completion of HPV vaccine. Among barriers to completion of HPV vaccine identified were: inadequate information about HPV infection and HPV vaccine, concerns about HPV vaccine efficacy and safety, unclear communication with adolescents/caregivers from healthcare workers and -stock out of the HPV vaccine.ConclusionTimely completion of the second dose of HPV vaccine among girls attending the adolescent clinic of Mulago hospital was low (at 43.3%) but higher when compared to earlier published reports. Interventions around improved social mobilization, enhanced outreach and static vaccination approach and education of eligible girls on HPV vaccination can help increase vaccine uptake
Depressive symptoms, sexual activity, and substance use among adolescents in Kampala, Uganda
No full textBackground: Adolescents experience high rates of depression, initiation of sexual activity, and substance use.Objectives: To better understand the demographics of adolescents presenting to an adolescent clinic in Uganda, and to elucidate which factors are associated with depressive symptoms, sexual initiation, and substance use.Methods: A retrospective review was performed on intake forms obtained during interviews with adolescents presenting to the Makerere/Mulago Columbia Adolescent Health Clinic (MMCAH) in Kampala, Uganda.Results: Depressive symptoms in adolescents were correlated with having a chronic illness (p=.026), and reported poor quality of home life (p<.001). Initiation of sexual activity was also correlated with chronic illness (p=.008) and poor quality of home life (p=.006). Substance use was correlated with maternal death (p=.041), chronic illness (p=.038), and substance use among family members (p<.001) and friends (p<.001).Conclusions: Knowing the aforementioned risk factors can help us better understand the needs of adolescents presenting toMMCAH, and allows us to develop targeted interventions aimed at decreasing health risks in Kampala’s adolescent population.Keywords: Depressive symptoms, sexual activity, substance use, adolescents, Uganda
Project Field Report for the Construction Of Residential Houses on Plot 3 Block 256, Munyonyo
No full textThis project report entails the construction methodology used and aspects of construction project
management practices exercised by the author while part of the construction team during the
construction of the 2No.residential villas on plot 3 block 256 Walugembe road Munyonyo.
It further details contract administration practices during the execution stage and the application
of project management knowledge areas during project implementation. The knowledge areas
discussed at length include scope, cost, time and quality management. The construction
methodology adopted by the contractor at every stage of the works has also been discussed at
length in this report.
The project was of a gated community estate consisting 2No.identical high-end residential villas
constructed for Mr. Frederick Mutebi Kitaka, a real estate developer who develops private closed
gated communities targeting a specific market niche.
Construction projects involve a diversity of skills that come from the diversity of professions,
specialists and suppliers that are involved in the process from inception to end. Successful
implementation of a project can only be achieved with good project management practices in
place. Failure to have proper project management monitoring and control systems can easily
result in poor relationships, disputes and cost and time overruns on a project
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