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ItemUptake of a single dose human papillomavirus vaccine among adolescent girls aged 13-19 years in Wakiso Dstrict, Uganda(Makerere University, 2026)Introduction: Cervical cancer remains a major public health challenge in Uganda, and Human Papillomavirus (HPV) vaccination is a key preventive measure. Despite national vaccination programs, coverage among adolescents remains suboptimal. This study assessed the uptake and factors associated with uptake of single-dose HPV vaccination among adolescent girls aged 13-19 years in Wakiso District. Methods: A mixed-methods cross-sectional study was conducted with 597 adolescent records extracted from African Medical and Behavioral Sciences Organization (AMBSO) Population Health Surveillance (APHS) and 58 participants through focus group discussions and key informant interviews, including adolescents, parents, health workers, Head teachers, and Village Health Teams (VHTs). Quantitative analysis included descriptive statistics and regression model using STATA 14.0 and qualitative data were thematically analyzed using NVivo version 15; QSR International, 2021. Results: The overall uptake of at least one dose of the HPV vaccine was 33.3%. Uptake was higher among Protestants (44.8%) than Catholics (33.3%), and among rural residents (47.3%) compared to urban residents (27.2%). Younger adolescents aged 13–15 years (42.9%) were more likely to have been vaccinated than those aged 16–19 years (27.8%). In multivariable modified Poisson regression, significant predictors of HPV vaccine uptake were Protestant religion (Adjusted PR = 1.36, 95% CI: 1.04–1.77, p=0.022), rural residence (Adjusted PR = 1.81, 95% CI: 1.46–2.24, p=0.001), and younger age (Adjusted PR = 0.63, 95% CI: 0.50–0.81, p=0.001). Facilitators included community outreach programs, peer encouragement, school-based vaccination program, and trust in health workers. Key barriers, were limited awareness (90.5%) and misinformation. Conclusion: Single-dose HPV vaccine uptake among adolescent girls aged 13-19years in Wakiso District remains low, largely due to inadequate awareness and sociocultural misconceptions. Strengthening community education, parental engagement, school-health facility programs, and continuous outreach is critical for improving coverage and advancing Uganda’s cervical cancer prevention goals. Keywords: HPV vaccine, adolescent girls, uptake, cervical cancer prevention.
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ItemDeveloping a social media middleware application to improve data accessibility for targeted DHIS2 users in Uganda(Makerere University, 2026)Access to data is very important in ensuring data utilization for service delivery improvement, proper resource allocation, and informing policies. This research resulted in the development of a middleware application integrated into the DHIS2’s application store that enabled reports generated in DHIS2 to be shared on preconfigured social media platforms like Telegram Messenger. The main objective of this research was to develop, test, and validate the feasibility and acceptability of a middleware application that extends access to DHIS2 data beyond the native system by leveraging social media platforms, particularly Telegram Messenger, to support timely data access and use within the routine communication and decision-making environments of health workers. The choice to use social media was informed by the reality that health workers already rely on platforms such as Telegram, WhatsApp, and others for routine coordination, supervision, and decision-making. Embedding DHIS2 data access within these existing communication ecosystems enhances timeliness, and aligns data use with users’ natural workflows. Methodology: The study applied the user-centered design approach by gathering requirements from purposively sampled users of DHIS2 for the development of the middleware application. Participants in the study included DHOs, Software developers from HISP- Uganda and participants from The Ministry of Health Division of Health information Data Center. Users were then asked to give their experience on whether the application improved data access and hence utilization during the study duration. Results The study revealed that there is positive reception of using social media platforms such as Telegram and WhatsApp and that it can actually improve data access in DHIS2 since it blends in well with the naturalistic settings of the DHIS2 users. It was also revealed in the study that uptake of the new technology was easier because it was simple and easy to use in the daily workflow of users. The study showed that improving data access can positively impact data utilization. However, there were concerns about privacy and security of data that called for more stringent measures to secure the information in future iterations of the middleware application.
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ItemAssessment of preconception folic acid use and associated factors among pregnant women in Wakiso district, Uganda: a facility based cross-sectional study(Makerere University, 2025)Background: Obstetric guidelines recommend women of childbearing potential to use Folic Acid (FA) three months prior conception. Preconception FA supplementation provides adequate serum FA levels necessary for prevention of up to 72% of Neural Tube Defects (NTDs). However, majority of pregnancies in low and middle-income countries are unplanned resulting in failure to use FA as recommended. There is limited data on use of FA during the preconception period in Uganda. This study assessed preconception FA use and associated factors among pregnant women attending antenatal care (ANC) in Wakiso district. Methods: A facility based cross-sectional study was conducted from 1st June 2025 to 31st August 2025 among 943 pregnant women 15-49 years attending their first antenatal care visit at four healthcare facilities in Wakiso district (Wakiso HCIV, Kajjansi HCIV, Kasangati HCIV and Ndejje HCIV). Pregnant women were then requested to voluntarily provide written Informed consent. A structured questionnaire was used to assess use of FA prior to conception. Descriptive and Firth-logit regression analyses were performed using Stata® version 14 to characterize factors associated with preconception FA use. Analysis was stratified by pregnancy planning status. Results: The overall uptake of preconception FA use was 3% (28/943) (95% CI: 2.0-4.3%). The uptake of preconception FA use among women with planned pregnancies was 3.5% (22/631) (95% CI: 2.2-5.2) which was not statistically different from women with unplanned pregnancies [1.9% (6/312) (95% CI: 0.7-4.1)]. The mean age of study participants was 25 years (SD 5.2) with 58.4% (551/943) of the respondents attending their first ANC visit in their second trimester. Awareness about preconception FA use was 52.9% (499/943). Muslim women were more likely to use FA during the preconception period, AOR 4.05 [95% CI: 1.06 - 15.52], P value 0.041. Health workers (P=0.014) and social media (P=0.049) were significant sources of knowledge about FA. Women who were aware of the recommended start period for using FA were more likely to take FA during the preconception period (P= 0.003). Conclusion: This study found a low uptake of FA during the preconception period by Women of Reproductive Age (WRA). Lack of awareness about FA was the primary barrier for non-users. Current FA uptake is insufficient to address Uganda’s NTD burden and current health education and policy are insufficient to prevent the high burden of NTDs in Uganda. MOH needs urgent, multi-channel health education campaigns through mass media and health workers to emphasize the necessity of starting FA supplementation three months before pregnancy. Further biochemical studies to quantify actual serum FA levels among WRA and explore deeper insights into the complex behavioural determinants and socio-cultural barriers underlying the low FA uptake in Uganda is urgently needed.
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ItemAssessment of Monitoring and Evaluation Practices in Management of Laboratory Reagent Stock Outs in Selected Regional Referral Hospitals in Uganda. A Concurrent Mixed Methods Study.(Makerere University., 2026-04-30)Background: Laboratory reagents are essential for accurate diagnosis and efficient healthcare delivery, yet Uganda’s referral hospitals frequently experience stockouts. These shortages delay diagnosis, compromise treatment decisions, increase healthcare costs, and reduce the overall quality of patient care. Aim: This study evaluated monitoring and evaluation(M&E) practices for managing stock out of laboratory reagents, facilitators and barriers to their application at Entebbe and Mbale regional referral hospitals. Methods: This study is a concurrent mixed-methods study. Data on stock out of laboratory reagents was collected from the stock cards and Order /Requisition forms, Electronic afya(E-AFYA) system in the laboratory using a checklist. Additional data was collected through key informant interviews of laboratory staff in Mbale and Entebbe regional referral hospitals. The interviews were audio recorded and data analyzed using thematic manual coding. Quantitative data was summarized in frequencies and inferential analysis was conducted using chi-square tests. Results: A total of 171 reagents experienced 848 stockout episodes from 2023–2025, with Entebbe RRH recording 66 reagents and 369 episodes, and Mbale RRH 105 reagents and 479 episodes. Entebbe had more frequent stockouts, while Mbale had fewer but longer episodes. Stockouts were most common in Immunology/Serology (37.6%) and Biochemistry (26.5%). The overall mean stockout duration was 26.7 days (SD: 39.3); Entebbe averaged 19.5 days (SD: 35.2) and Mbale 35.9 days (SD: 42.2). A Chi-square tests (p < 0.05) showed significant differences in stockouts between the two hospitals for Microbiology/Parasitology and Immunology/Serology, but not for Hematology and Biochemistry. Qualitative findings indicated that stock monitoring tools, electronic inventory systems, supervision, audits, and reporting mechanisms were in place in both hospitals but were applied inconsistently. Mbale achieved full implementation of the Electronic afya (E-AFYA) system in May 2025, with earlier records maintained manually, while Entebbe had relatively more organized documentation; nevertheless, both facilities demonstrated data quality challenges, including incomplete stock cards, missing records, and inconsistent requisition forms. Use of M&E data for decision-making and accountability was limited. Facilitators included leadership support, availability of digital tools, and inter-facility redistribution of reagents, whereas barriers included staff shortages, weak data-use culture, and irregular supervision. Conclusion: Strengthening M&E systems including better data quality, reporting, supervision, staff capacity, and digital tools will enhance stockout management and ensure sustained reagent availability.
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ItemTrends of childhood vaccination in Wakiso District(Makerere University, 2026)Introduction: While immunization remains one of the most successful interventions in public health, the coverage has flattened over the last decade. And so many children don’t get a single vaccine dose and while others take vaccine doses partially. Objectives Main objective: To evaluate the trends of childhood vaccination in Wakiso district in order to improve the childhood vaccination services in the district. Specific objectives 1. To determine the trend of childhood vaccination drop-out rates for DPT 1 to DPT3, MR 1 to 2, to PCV3 and HPV1 to HPV2 between October 2021 and September 2022. 2. To establish the trend of childhood vaccination coverage in Wakiso district between October 2021 and September 2022. Methods: It was a cross-sectional study. All records of children who received at least one dose of the childhood vaccines were used in the study from October 2021 to September 2022. Results: The drop-out rates were very high especially for Measles Rubella vaccine and Human Papilloma Vaccine. The vaccination coverage was very low with Measles Rubella vaccine and Human Papilloma Virus vaccine coverage taking the lowest position. Conclusions & Recommendations: There should be strategies that decrease vaccination drop-out and increase vaccination coverage.