Papers by Dr Omona Kizito
Cogent Public Health, 2022
Maternal near misses (MNM) involve near-death experiences and are associated with severe maternal... more Maternal near misses (MNM) involve near-death experiences and are associated with severe maternal morbidity, not limited to severe postpartum haemorrhage, sepsis and organ dysfunction. Maternal near misses are quite common in Ugandan health facilities. This study aimed to assess the prevalence and determinants of maternal near misses among women who sought obstetric care from Fort Portal Regional Referral Hospital, western Uganda. A retrospective cohort study that targeted 375 women who had received maternal healthcare services from Fort Portal regional referral hospital was undertaken. It was found that, overall, the
prevalence of MNM was 61.3%, with sepsis being the commonest determinant [187(81.3%)]. Eight individual characteristics had statistically significant relationships with MNM; residence type (p = 0.000), trimester of initiation of ANC (p = 0.000), ANC attendance (p = 0.048), delivery of recent pregnancy in health facility (p = 0.000), delivery at Fort Portal regional referral hospital (p = 0.000), referred from other facilities (p = 0.000), age (p = 0.037), marital status (p = 0.000) and district of residence (p = 0.000). The prevalence of MNM was higher among women who were of rural residence at 45.6% (aPR = 1.409 [1.330–1.493], p = 0.000), compared to those who were of urban residence. MNM prevalence was very high among mothers who never attended ANC at 3.2% and thus, less among those who had attended ANC during pregnancy (cPR = 0.652 [0.216–0.981], p = 0.048). Conclusively, the prevalence of MNM was substantially high.
International Journal of Studies in Nursing
In order to equip practitioner midwives and nurses, I find ‘Empowering Midwives and Obstetric Nur... more In order to equip practitioner midwives and nurses, I find ‘Empowering Midwives and Obstetric Nurses’ a book to be treasured. This is more especially when it comes to supporting learning and preparing readers for the challenges faced in contemporary healthcare. This book with 192pages and twelve chapters is a treasure.
Introduction: The delivery of health care is known to involve potential safety risks for the pati... more Introduction: The delivery of health care is known to involve potential safety risks for the patients who are supposed to benefit from medical treatment and care. Over the years, efforts have been put in place to reduce the occurrence of safety risks and improve on patient quality of care. Both the health care providers and patients have their respective roles to play. Bringing on board patients in efforts to minimise safety risks, also known as patient engagement, proved effective. Objectives: The objectives of the study were; to ascertain the level of awareness about patient safety in healthcare among patients and health workers, to determine the level of health workers engagement in patient safety in healthcare, assess the level of patient engagement in patient safety, as well as to determine the factors affecting patients and health workers engagement in patient safety in health care in Kitgum General Hospital. Methods: This was a descriptive, cross sectional study of patients and health workers' engagement in patient safety in healthcare in Kitgum General Hospital (KGH). The study took both qualitative and quantitative dimensions. A probability sample of 384 patients was interviewed using structured questionnaires and 103health workers were studied by observation and key informant interviews. Documentation review of previous patient files (50files) was carried out to assess the depth of patient identification, as a measure to minimize medical errors. Pre-testing of the questionnaires and training of research Assistants were done prior to the study to ensure quality of the research. Ethical considerations in research were strictly adhered to. Results: The level of awareness about patient safety among patients and health workers was found to be 46.5% and 51% respectively. The level of health workers engagement in patient safety was found to be 51.4% while engagement of patients in patient safety was at 52.1% The factors affecting patients and health workers engagement were mainly demographic factors such as age and level of education, among others. Conclusion: In conclusion, health workers in KGH were 4.5% more aware about patient safety than the patients. However, patients in KGH are 0.7% more engaged in patient safety than the health workers.
International Journal of Medicine
Introduction: Young people in adolescent stage are very vulnerable. Sexual and reproductive healt... more Introduction: Young people in adolescent stage are very vulnerable. Sexual and reproductive health choices they make as they transition from childhood to adulthood determine a lot about their well-being.Objective: To assess the role of religious leaders in promoting adolescent sexual and reproductive health rights in Iganga Municipality.Methodology: Qualitative phenomenological design was used. Sample of 30 participants (25religious leaders and 5adolescents) were interviewed. Data was collected using in-depth interviews, transcribed, coded and analyzed using thematic content analysis.Results: Information shared by religious leaders to adolescents helped them to live responsible lives. Results also indicated that; religious leaders perceived promotion of ASRHR to imply elevation of sexual immorality. Religious leaders had both protective and preventive influences on promotion of ASRHR.Conclusion: Religious leaders greatly contribute to promotion of ASRHR by enhancing information shar...
Cogent Medicine
Abstract: Caesarean delivery, often called a C-section, is the delivery of the baby through incis... more Abstract: Caesarean delivery, often called a C-section, is the delivery of the baby through incisions in the mother’s abdomen and uterus. Caesarean deliveries, whether elective or medically necessa...
Cogent Medicine, 2021
Introduction: Post-operative sepsis tends to complicate the recovery course of many patients. Acr... more Introduction: Post-operative sepsis tends to complicate the recovery course of many patients. Across the globe, the proportion of post-operative sepsis varied from 2.9% to 30% in various studies. Objectives: To determine mean proportion of post-operative sepsis in Maternity and General Surgical wards (GSW) and establish whether there was a significant difference in the proportion of post-operative sepsis between the two departments. Materials & Methods: The design was part of an Unmatched Retrospective Cohort study of post-operative patients admitted to the Maternity and General Surgical ward over the past 6 months. Random samples of 169 respondents from Maternity and 245 respondents from GSW were compared. Results: Mean proportion of post-operative sepsis was 4.4% and 3.1% for Maternity ward and GSW, respectively. Test statistic, Z2 (4.98) � , Z1 (1.96), fell in the rejection region; hence, Ho was rejected (significant difference in the proportion of sepsis). In the Maternity ward, the risk of postoperative sepsis was more among the unmarried (p = 0.023, COR = 5.550 [1.272–24.219] at 95% CI). In General Surgical Ward (GSW), emergency surgery (11.9%) and complex surgeries (16.3%) carried more risk. Risk of post-operative sepsis in maternity was more among the unmarried (27.3%). For GSW, emergency surgery (11.9%) and complex surgeries (16.3%) carried more risk. Conclusion: Therefore, more effort is needed to combat post-operative sepsis.
Annually, approximately 125 million pregnancies occur globally in malaria endemic areas. 25 milli... more Annually, approximately 125 million pregnancies occur globally in malaria endemic areas. 25 million pregnant women are at risk for malaria which accounts for over 10,000 maternal and 200,000 neonatal deaths annually. WHO recommends initiation of IPT3+ in malaria endemic areas beginning with second trimester throughout pregnancy? However, uptakes of IPT3+ remain low in many countries, for instance in Uganda, the coverage of IPT3+ remains low at 66%.
Immunization is one of the worlds’s most cost-effective health interventions that help prevent ch... more Immunization is one of the worlds’s most cost-effective health interventions that help prevent childhood diseases. However, many infants are not usually fully vaccinated especially in developing countries. This contributes to the mortality of Vaccine-Preventable Diseases (VPD) in children. The study examined the socio-cultural factors that are associated with incomplete routine immunization of children aged 0–1 year old in Amach Sub-County, Lira District _ Uganda. An analytical cross-sectional-mixed study among a sample of 326 parents and three health workers were made. Simple random sampling and purposive techniques were used to select the respondents. In-depth interviews, focus group discussion and Interviewer administered questionnaires were used to collect data. A modified Poisson regression model was used to compute the prevalence ratios. Variables were analyzed at bivariate and multivariate levels for their association with incomplete immunization. Incomplete immunization was ...
Early ANC attendance is vital for early identification of pregnancy related health risks to eithe... more Early ANC attendance is vital for early identification of pregnancy related health risks to either mother or baby or both, and interventions instituted. This results in good delivery outcomes.
International Journal of Health
Background: Induced abortion is one where products of conception are expelled before 28 weeks of ... more Background: Induced abortion is one where products of conception are expelled before 28 weeks of gestation. The process can be safe or unsafe. Safe termination of pregnancy is performed by skilled persons using appropriate tools whereas unsafe induced abortion is performed either by persons without the necessary skills or in an environment without the minimum medical standards, or both.Objectives: To explore the lived experiences of women who had induced abortion in Rakai DistrictMethodology: Phenomenological qualitative design was used. Study population was women who underwent induced abortion. 25 women who had induced abortions in past 1-3years were interviewed. Data was collected by in-depth interviews, tape recorded; transcribed verbatim and written in note book.Results: Lived experiences included denial, shame, confusion, fear, anger, anxiety, depression and uncertainty. Participants reported use of local herbs like “ekiwoko” and “majaani”, “etwaata”, “kisuula” and roots of sug...
TEXILA INTERNATIONAL JOURNAL OF PUBLIC HEALTH
Introduction: The third delay is the delay in receiving adequate and appropriate treatment at the... more Introduction: The third delay is the delay in receiving adequate and appropriate treatment at the healthcare facility by mothers during and after pregnancy. A number of factors are attributable to this delay. Aim: To identify factors that led to internal delay in management of obstetric emergency, to identify measures to address them and determine the lived experiences of mothers who received obstetric emergency care in Midigo HC IV. Methods: Purely descriptive cross-sectional design; both qualitative and quantitative in nature. Sample size was 36 participants (33 health workers and 3 mothers). Results: Factors like long hours of work due inadequate staffing (80%), inadequate refresher training on EmONC (66.7%), poor referral system, poor lighting system, inadequate blood transfusion services and hostility of the community led to delays. Qualitative analysis from mothers confirmed these factors. Measures that could be used to address them were; use of Workload Indicator of Staffing Needs (WISN) to adequately allocate staffs-90%, holding periodic refresher training on EmONC-93.3%, availability of full-time doctors and anaesthetists (93.3%). Other measures were revamping referral system (93.3%). Conclusion: Third delays in accessing Emergency Obstetric Care (EmOC) are still a huge challenge in Uganda _ Midigo HC IV.
TEXILA INTERNATIONAL JOURNAL OF PUBLIC HEALTH
Introduction: Many adolescents often lack strong and stable relationships with their parents to o... more Introduction: Many adolescents often lack strong and stable relationships with their parents to openly discuss reproductive health concerns. Parents often have the power to guide children's development in sexual health matters, encouraging them to practice reasonable sexual behaviours. Objective: The study aimed at ascertaining the level of involvement of parents in sexuality education of their adolescents in Hoima municipality and the associated factors. Methodology: It was both descriptive and analytical across-sectional study and used both qualitative and quantitative methods. 213 Participants were randomly selected and interviewed using semi structured questionnaires. Results: Most of the parents (81.7%) reported to be involved in sexuality and reproductive health education of their adolescents. Females were 1.18 times more likely to be involved in sexuality education (CPR=1.18; CI= 1.02-1.37; p-value 0.02). Parents were 1.56 times more likely to be actively involved in talking to their adolescents about sexuality education compared to other people (APR=1.56; CI= 1.22-1.99; p-value < 0.001). Having both parents were 1.22 times more likely to equally talk to their children about sexuality and reproductive health (CPR=1.22; CI=1.07-1.40; p-value= 0.004). Mothers were 1.64 times more likely to be involved in teaching their children on this subject matter than fathers (APR=1.64; CI=1.15-2.34; p-value 0.006). Conclusion: Factors associated with parents' involvement in sexuality education were; female headship of family, being a traditional believer and widow/widower. SRH services should, therefore, be availed in all the health units, where both adolescents and parents can easily access.
TEXILA INTERNATIONAL JOURNAL OF MEDICINE, May 30, 2018
Introduction: The third delay is the delay in receiving adequate and appropriate treatment at the... more Introduction: The third delay is the delay in receiving adequate and appropriate treatment at the healthcare facility by mothers during and after pregnancy. Many factors attribute to this; shortage of staff, insufficient training, antibiotic unavailability and equipment among others. Objectives: The purpose of the study was to ascertain the preparedness of Arua regional referral hospital to handle referred emergency obstetrics cases. Methods: A qualitative contextual descriptive phenomenological design was used. A sample of six (6) carefully selected mothers and four (4) midwives were used. Triangulation of methods was used to enhance quality. Transcriptions of the interviews was analyzed using descriptive thematic analysis Findings: As per WHO criteria, Arua Regional Referral Hospital was rated as a fully functional EmOC facility. Out of the 6 respondent mothers, two had received Emergency Obstetric Care three times from the facility while the rest of them received EmOC more than 5times. When asked about history of having been referred out, non of them was referred out. Again, when asked about the outcome of all their deliveries, four out of 6 had good maternal outcomes whereas 2 had bad maternal outcomes. Conclusion: Arua RRH remains an EmOC Health Facility, falling in keeping with the World Health Organization standard as well as the Uganda national standard, although some improvements are still wanting. Recommendation: The hospital needs to embark on training other surrounding health facilities on EmOC.
TEXILA INTERNATIONAL JOURNAL OF PUBLIC HEALTH
Introduction: Sanitation refers to the provision of facilities and services for the safe disposal... more Introduction: Sanitation refers to the provision of facilities and services for the safe disposal of human urine and faeces whereas Hygiene is a set of personal practices that contribute to good health. It includes things like hand-washing, bathing and so forth. Objectives: The purpose and rationale of this project was to improve sanitation and hygiene in Kerwa Sub county. Methods: The project (2years) employed both qualitative and quantitative mixed designs in Kerwa Sub county, located, in Yumbe district, Uganda. Implementation period was from April, 2015 to November, 2016. Results: The total number of households with latrines increased from 775 (43.3%) in the baseline to 1215 (67.8%) in the first year of project implementation then to 1579 (88.2%) in the second year. Similarly, open defecation dropped from 56.7% in the baseline to 32.2% in the first year of project implementation and further to 11.8% in the second year. Hygiene status, measured using hand washing, almost remained the same between baseline and first year of project implementation at about 0.9%. It significantly improved to 20.8% in the second year. Through application of statistical thinking, final reporting time reduced by 60 days, from 210 days before statistical thinking approach to 150 days after the application. Conclusion: Statistical thinking remains a key process of continuous quality improvement in any industry.
TEXILA INTERNATIONAL JOURNAL OF CLINICAL RESEARCH
Introduction: Globally every day, about 830 women die due to complications of pregnancy and child... more Introduction: Globally every day, about 830 women die due to complications of pregnancy and child birth. Of these deaths, 99% occur in low-resource settings, and most could be prevented. Use of Modified Early Obstetric Warning System (MEOWS) would be appropriate. MEOWS is a monitoring chart intended to identify mothers at risk and initiate the right action, at right time by the appropriately skilled clinicians, at a time when treatment might make a difference to reduce maternal mortality and morbidity. Objectives: To determine the sensitivity, specificity and predictive values of Modified Early Obstetric Warning System (MEOWS) in correctly identifying women at risk of developing obstetric morbidity in St. Francis Hospital_Nsambya between January and February, 2016 Methods: The study was a prospective cohort study conducted at St. Francis Hospital Nsambya, maternity ward, from January to February 2016. MEOWS monitoring tool was used alongside with questionnaires. Result: 502 respondent mothers were enrolled in the study. 160patients (31.9%) triggered and of which: 11.5% of them had obstetric morbidity which included postpartum haemorrhage-35.5%, preeclampsia-26.3%, suspected infection-22.4%, third degree perineum tear-5.3%, anaesthetic complications-4% and prolong hospital stay-7%. MEOWS was 81.7% sensitive (95% CI 80-94%), 76.3% specific (95% CI 74-81%), with a positive predictive value 36.3% (95% CI 31-44%) and negative predictive value of 96.2% (95% CI 94-99%). Conclusion: MEOWS chart is even effective for use in low resource setting, like Uganda.
Molecular Pharmaceutics
Drug crystallization on and in the skin has been reported following application of topical or tra... more Drug crystallization on and in the skin has been reported following application of topical or transdermal formulations. This study explored novel probe-based approaches including localized nano-thermal analysis (nano-TA) and photothermal microspectroscopy (PTMS) to investigate and locate drug crystals in the stratum corneum (SC) of porcine skin following application of simple ibuprofen (IBU) formulations. We also conducted in vitro skin permeation studies and tape stripping. The detection of drug crystals in the SC on tape strips was confirmed using localized nano-TA, based on the melting temperature of IBU. The melting of IBU was also evident as indicated by a double transition, and confirmed the presence of drug crystals in the SC. The single point scans of PTMS on the tape strips allowed collection of the photothermal FTIR spectra of IBU, confirming the existence of drug crystals in the skin. The combined methods also indicated that drug crystallized in the SC at a depth of ~4-3 7 µm. Future studies will examine the potential of these techniques to probe crystallization of other commonly used actives in topical and transdermal formulations.
TEXILA INTERNATIONAL JOURNAL OF MEDICINE, 2016
Introduction: Medical incident reporting is a key tool for improving patient safety in healthcare... more Introduction: Medical incident reporting is a key tool for improving patient safety in healthcare, hence improved quality of care. The better the knowledge, attitude and practice of this concept, the better the quality of care. The perceived knowledge, attitude and practice are still low in many Uganda healthcare facilities. Many of the healthcare providers have, therefore, limited their scope to maternal death audit and reporting or perinatal death reporting and to a greater extent Adverse Event Following Immunization (AEFI). This problem of perceived low knowledge, attitude and practice of incident reporting is coupled with the poor institutional culture to persistently and inadequate support healthcare professionals to report incidents. Medical incident reporting is, therefore, the single most powerful tool for developing and maintaining an awareness of risks in healthcare practice, hence a cornerstone to improved patient safety and improved quality of service delivery. Objectives: The study objectives were as follow; to assess the level of knowledge about medical incident reporting among healthcare professionals, by April, 2016 and determine their attitude towards medical incident reporting. The researcher also set out to ascertain the practice and the extent to which medical incident reporting is practiced in Midigo Health Centre IV, as well as, establishing the factors affecting medical incident reporting in the said healthcare facility. Methods: The study was a cross sectional study of knowledge, attitude and practice of medical incident reporting among Healthcare Professionals in Midigo health centre IV. It was both qualitative and quantitative; with a sample of 44healthcare professionals interviewed using structured questionnaires. The questionnaire was pre-tested. Analysis of result was done using computer packages called Statistical Package for Social Sciences (SPSS) and Microsoft excel. Ethical considerations in research were observed. Results: The cadre of the respondents were; Medical officers -4.5%, Clinical officers -6.8%, .2%. The response rate was 100%. The level of knowledge about medical incident reporting among healthcare professionals in Midigo HC IV was at 84.1%, by April 2016. Much as there was no statistical significance between cadre of staffs and extent of knowledge, p-value >0.39, the only cadres that had excellent knowledge on medical incident reporting were nurses (75%) and clinical officers (25%). The rest of the staffs either had average knowledge or fair knowledge or no knowledge at all. The healthcare professionals had strong positive attitude towards medical incident reporting and this was at 97.7%. By April, 2016, the practice of medical incident reporting was at 72.6% with the majority of these respondents (up to 50%), having participated in reporting three times or more for the last 5years. The major factors that facilitated the respondents to report were; Strong positive feeling to participate and improve patient safety and respondents were knowledgeable (educated) about medical incident reporting. Other minor factors like ability of respondents to get feedback on reported incidents and strong institutional culture of reporting did not make strong contribution towards the practice of reporting. However, the major barriers were; respondents didn't know where and how to report, coupled with weak institutional culture of reporting incidents. Surprisingly, fear of consequence of reporting did not in any
Cognizance Journal of Multidisciplinary Studies
Introduction: Postnatal period is the time shortly after birth of the baby and extending up to si... more Introduction: Postnatal period is the time shortly after birth of the baby and extending up to six weeks. This period is recognized as very critical for survival of both the mother and the baby. Recent guidelines recommend four postnatal care contacts with skilled health personnel for the health and well-being of mother and newborn.
International Journal of Studies in Nursing
Background: The Ik are minority group of people in Kaabong district, Uganda. They are the most ma... more Background: The Ik are minority group of people in Kaabong district, Uganda. They are the most marginalized. In addition, little is known about their perceived SRH needs and barriers to accessing SRH services.Objective: To determine perceived needs and barriers to accessing SRH services by the Ik community.Material and Methods: A cross-sectional analytical design with analytical was used, both quantitative and qualitative (mixed methods). Data was collected using key informant interviews, focus group discussions and semi-structured questionnaires. Sample of 345 participants selected randomly and purposively. Qualitative analysis was thematic whereas Statistical Package for Social Scientists (SPSS) was for quantitative analysis.Results: Perceived SRH needs of the Ik were; limited access to SRH information, lack of protection from gender-based violence and lack of access to comprehensive safe motherhood programs. Access to SRH services was limited mainly by poverty, limited range of a...
International Journal of Studies in Nursing
Background: Traditional and complementary medicine is globally accepted and steadily gaining popu... more Background: Traditional and complementary medicine is globally accepted and steadily gaining popularity among populations. The practices of conventional health care workers toward it vary from one country or setting to another. Limited literature exists on practices of health workers towards this form of medicine in low income settings especially in Africa where it is widely used with limited collaboration, integration and regulation.Purpose: To determine the prevalence and determinants of traditional and complementary medicine practices as well as health problems and reasons for its use among nurses and midwives in North Western Uganda.Materials & Methods: We used a descriptive and analytical cross-sectional design. Data was collected using self-administered structured questionnaires that were distributed to a sample of 300 nurses and midwives drawn from 6 hospitals. Descriptive statistics, chi squared and multiple binary logistic regression analysis were used for analysis.Results:...
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Papers by Dr Omona Kizito
prevalence of MNM was 61.3%, with sepsis being the commonest determinant [187(81.3%)]. Eight individual characteristics had statistically significant relationships with MNM; residence type (p = 0.000), trimester of initiation of ANC (p = 0.000), ANC attendance (p = 0.048), delivery of recent pregnancy in health facility (p = 0.000), delivery at Fort Portal regional referral hospital (p = 0.000), referred from other facilities (p = 0.000), age (p = 0.037), marital status (p = 0.000) and district of residence (p = 0.000). The prevalence of MNM was higher among women who were of rural residence at 45.6% (aPR = 1.409 [1.330–1.493], p = 0.000), compared to those who were of urban residence. MNM prevalence was very high among mothers who never attended ANC at 3.2% and thus, less among those who had attended ANC during pregnancy (cPR = 0.652 [0.216–0.981], p = 0.048). Conclusively, the prevalence of MNM was substantially high.
prevalence of MNM was 61.3%, with sepsis being the commonest determinant [187(81.3%)]. Eight individual characteristics had statistically significant relationships with MNM; residence type (p = 0.000), trimester of initiation of ANC (p = 0.000), ANC attendance (p = 0.048), delivery of recent pregnancy in health facility (p = 0.000), delivery at Fort Portal regional referral hospital (p = 0.000), referred from other facilities (p = 0.000), age (p = 0.037), marital status (p = 0.000) and district of residence (p = 0.000). The prevalence of MNM was higher among women who were of rural residence at 45.6% (aPR = 1.409 [1.330–1.493], p = 0.000), compared to those who were of urban residence. MNM prevalence was very high among mothers who never attended ANC at 3.2% and thus, less among those who had attended ANC during pregnancy (cPR = 0.652 [0.216–0.981], p = 0.048). Conclusively, the prevalence of MNM was substantially high.
humans, through the vagina, also known as the “birth canal”. It is the natural method of birth for most mammals excluding those which lay eggs. For women who deliver vaginally, childbirth progresses in three stages: labor, delivery of the baby and delivery of the placenta. There are two types of vaginal delivery: Unassisted vaginal delivery and assisted vaginal delivery. In the later, this assistance can vary from use of medicines to emergency delivery procedures. The following types of
vaginal delivery have been noted; (a) Spontaneous vaginal delivery (SVD) (b)Assisted vaginal delivery (AVD), also called instrumental vaginal delivery (c)Induced vaginal delivery and (d) Normal vaginal delivery (NVD), usually used in statistics or studies to contrast with a delivery by cesarean section. Delivery of a full-term newborn occurs at a gestational age of 37–42 weeks, usually determined by the last menstrual period or ultrasonographic dating and evaluation. Nearly 80% of newborns are delivered at full term while approximately 10% of singleton pregnancies are delivered preterm and 10% of all deliveries are post-term.