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Jul 2026 DOI 10.14302/issn.2693-1176.ijgh-26-6309
Joan NakkaziCorresponding author
Introduction Young pregnant mothers experience heightened biological, social, and economic vulnerabilities that may compromise health-related quality of life (HRQoL), especially in low-resource settings. Although maternal healthcare service utilization (MHCSU) improves clinical outcomes, evidence linking it to HRQoL among young mothers in Uganda remains limited. This study examined determinants of HRQoL among young pregnant mothers aged 10–24 years in Eastern Uganda, with emphasis on MHCSU. Methods A cross-sectional analytical study was conducted among 967 young pregnant mothers in selected districts of Eastern Uganda. The study used baseline data collected prior to randomization and implementation of any intervention. Although the WHOQOL-BREF instrument was administered in full, the present analysis utilized the global quality-of-life item (Question 1: "How would you rate your quality of life?") as the primary outcome measure. Responses ranged from very poor (1) to very good (5) and were analyzed as an ordinal outcome using ordered logistic regression. Data were analyzed using descriptive statistics, ANOVA for bivariate associations and ordered logistic regression models to assess predictors of HRQoL, all conducted at a 95% confidence level. Results Results from the bivariate analysis indicated that uptake of antenatal care (ANC), skilled birth attendance (SBA), and access to postnatal care (PNC) were associated with better health-related quality of life (HRQoL) among young pregnant mothers. Mothers who attended antenatal care reported higher mean HRQoL scores compared to those who did not (2.98 ± 1.12 vs. 2.66 ± 0.96, p = .001), demonstrating that ANC utilization is positively linked to maternal well-being. Similarly, mothers who delivered with the assistance of skilled birth attendants had higher HRQoL scores than those who did not (3.00 ± 1.11 vs. 2.65 ± 0.97, p < .001), indicating the importance of skilled delivery care in improving quality of life. Access to postnatal care also showed a positive association, with mothers who received PNC services reporting higher HRQoL scores compared to those who did not (2.97 ± 1.12 vs. 2.71 ± 1.10, p = .003). Overall, these findings suggest that increased utilization of maternal healthcare services is consistently associated with improved HRQoL among young pregnant mothers. In the ordered logistic regression analysis, ANC uptake remained a statistically significant predictor of HRQoL (OR = 1.686, p < .001), indicating that mothers who accessed ANC services had approximately 1.69 times higher odds of being in better quality of life categories compared to those who did not. Similarly, skilled birth attendance was positively and significantly associated with HRQoL (OR = 1.761, p < .001), suggesting that mothers who delivered with skilled health personnel were more likely to report improved quality of life outcomes. Access to postnatal care also demonstrated a significant positive effect (OR = 1.552, p = .002), implying that mothers who received PNC services had higher odds of better HRQoL. In the multivariable model, immediate health-seeking behavior remained a significant predictor (OR = 1.411, p = .006), indicating that prompt care utilization increases the likelihood of improved well-being. Conversely, perceived quality of care was negatively associated with HRQoL; compared to mothers who perceived care as excellent, those who rated care as good (OR = 0.394, p < .001), fair (OR = 0.083, p < .001), and poor (OR = 0.077, p < .001) had significantly lower odds of reporting better quality of life. These findings highlight the critical importance of perceived care quality in shaping maternal well-being. Conclusion Maternal healthcare service utilization and positive care experiences were significantly associated with better HRQoL among young pregnant mothers. Expanding access to ANC, SBA, and PNC alongside respectful, youth-responsive care is essential to improve maternal well-being in Eastern Uganda.
Jul 2026 DOI 10.14302/issn.2693-1176.ijgh-26-6308
Joan NakkaziCorresponding author
Introduction Skilled birth attendance (SBA) is a proven intervention for reducing maternal and newborn morbidity and mortality through the prevention and management of childbirth complications. While its survival benefits are well established, less is known about its association with health-related quality of life (HRQoL), an important indicator of women’s physical, psychosocial and social well-being. Evidence on this relationship remains limited among young mothers in low resource settings such as Uganda. This study examined the association between SBA and HRQoL among young mothers aged 10-24years in Eastern Uganda. Methods A cross-sectional study was conducted among 967 young mothers in Kamuli, Pallisa, and Ngora districts. Participants were young mothers aged 10–24 years who had delivered within the previous two years. Data were collected using structured interviewer-administered questionnaires. HRQoL was assessed using the WHOQOL-BREF tool on a five-category self-rated scale. Descriptive statistics summarized participant characteristics, chi-square tests and One way ANOVA explored bivariate associations, and ordered logistic regression estimated the relationship between SBA and HRQoL. Skilled birth attendance was defined as delivery assisted by a trained and accredited health professional (doctor, nurse or midwife) in accordance with WHO recommendations. Results Most respondents were aged 18–24 years (91.3%), married (75.8%), and had prior pregnancy experience (90.4%). Bivariate analysis demonstrated that skilled birth attendance (SBA) utilization was significantly associated with several key factors, including age (χ²(1)=5.75, p=0.017), religion (χ²(1)=18.09, p<0.001), knowledge of maternal healthcare services (χ²(1)=26.84, p<0.001), seeking care immediately (χ²(1)=38.82, p<0.001), perceived quality of care (χ²(3)=71.90, p<0.001), and previous pregnancy complications (χ²(1)=6.91, p=0.009). These findings indicate that younger mothers, those lacking awareness, and those reporting poorer care experiences were less likely to deliver with assistance of skilled birth attendant. An ordered logistic regression analysis further established that utilization of SBA was a significant predictor of health-related quality of life (HRQoL) (z = 4.12, p < 0.001). Young mothers who delivered with the assistance of a skilled birth attendant had significantly higher odds of reporting better HRQoL compared to those who did not (OR = 1.761, 95% CI 1.345 2.306), implying that SBA users were approximately 1.76 times more likely to fall into a higher HRQoL category. The overall model was statistically significant (LR χ² (1) = 17.01, p < 0.001), although the pseudo-R² of 0.006 suggests limited explanatory power. Nonetheless, the findings highlight the independent contribution of SBA to improved maternal well-being, underscoring its importance in enhancing quality of life among young mothers. Conclusion Skilled birth attendance was positively associated with better HRQoL among young mothers in Eastern Uganda. Expanding equitable access to skilled delivery care may enhance physical safety, emotional well-being, and overall quality of life for this vulnerable population.
Dec 2024 DOI 10.14302/issn.2474-9273.jbtm-24-5317
Ndje Mireille NdjeCorresponding author
Adolescence in Cameroon, as in many parts of sub-Saharan Africa, is often marked by early childbearing. Studies have shown a national prevalence of adolescent deliveries to be around 14.2% - 14.4%, a higher rate than the average for sub-Saharan Africa This presents a unique challenge for young mothers, who must navigate the complex process of identity reorganization while still navigating their own adolescence with its multiple changes. This article explores the experiences of primiparous (first-time) Cameroonian adolescents as they transition from daughters to mothers. The objective of this article is to understand how identity reorganization takes place among primiparous Cameroonian adolescents who pass without transition from the status of daughter to the status of mother. Drawing on qualitative data from semi-structured interviews, with seven participants chosen on the basis of selection criteria, the article examines the psychological, social, and cultural factors that shape this identity shift. An interview guide with three main themes made it possible to collect verbatim comments from the participants. The thematic analysis highlights the challenges faced by these young mothers, such as navigating social stigma, managing emotional upheaval, and balancing motherhood with their own developmental needs. The findings of this study highlight the complex and multifaceted nature of identity reorganization among primiparous Cameroonian adolescents. The social stigma associated with early childbearing, coupled with the emotional and practical demands of motherhood, can pose significant challenges to these young women. However, a study on a larger sample could reveal the resilience and resourcefulness of some adolescents, who find support within their communities and employ various coping mechanisms to navigate this transition. Finally, the article discusses the implications of these findings for adolescent maternal health interventions and social policy in Cameroon.
Oct 2022 DOI 10.14302/issn.2641-4538.jphi-22-4281
Nakachwa MariaCorresponding author
School of Post Graduate Studies and Research, Nkumba University, Entebbe 237, Uganda
Uganda still grapples with a high maternal mortality rates of 336 deaths per 100,000. Expectant mothers across the country lack awareness about the availability of antenatal care services; yet attendance of antenatal care services during pregnancy is crucial in protecting the health of women and unborn children. This article describes a protocol for investigating the effectiveness of mobile telephone communication interventions on the utilization of antenatal care services among expectant mothers in the districts of Kyotera and Rakai Districts in Uganda. Under the protocol, 28 health facilities in the districts of Kyotera and Rakai will be selected using simple random sampling and allocated into the intervention and control arms at a ratio of 1:1. A total of 2224 expectant mothers receiving antenatal care from the sampled health facilities will be recruited using systematic sampling. Expectant mothers receiving antenatal care from facilities allocated into the intervention arm will receive mobile telephone voice and text messages reminders for scheduled ANC visits. The mobile telephone messages will further provide maternal health information and availability of ANC services on a fortnightly basis. On the other hand, expectant mothers receiving antenatal care from facilities allocated into the control group will not get any reminders for scheduled ANC visit and maternal health information through the mobile telephone communication platform. Expectant mothers in the control arm will receive standard maternal health care without reminders. Expectant mothers in both groups will provide baseline data, midterm data will be obtained from the ANC registers at 6 moths while end of term data will be collected after an intervention period of 12months. The data collected will include the number of antenatal care visits attended, antenatal care services obtained from the health facilities, sociodemographic factors and mobile telephone usage, ownership and knowledge. The anticipated outcomes are; increased awareness and utilization of ANC services.
Oct 2022 DOI 10.14302/issn.2641-4538.jphi-22-4313
Niyonkuru MathieuCorresponding author
Public Health Department, Mount Kenya University Rwanda
Data quality is defined as a measure of data status that fulfills the following elements: accuracy, completeness, consistency, reliability, and if the data is current. The World Health Organization (WHO) reported that only 40% of all countries have an adequate system to collect information on birth and deaths. Even though the system is there, vital registration systems are inaccurate and incomplete in developing countries. In Rwanda, maternal health related data was over-reported more than other indicators. These are the main reasons for conducting the study to investigate the data quality of four maternal and newborn health indicators reported by Rwandan Western Province health centers. This concurrent-mixed method study included 61 data managers and 12 key informants. Routine data quality assessment tool and structured interview guide were used to collect data. Descriptive statistics were used to get proportion of respondents’ socio-demographic characteristics. The analysis was done for assessing median of data quality index. The results show that 55.7% of data managers were male while 58.3% of responsible of maternity were female. Majority (58.9%) of participants was in age’s category from 33-42, 61.6% have A1 education level and 53.4% have experience less than five years. Data quality index of one out of four (25%) MNH indicators was found below 95% accepted by WHO. The main reasons for insufiscient quality of data are lack of data validation meetings (57.5%) and incompleteness of reporting tools (36.4%). Monthly data validation meetings chaired by HC leaders are important to contribute to high-quality data in healthcare settings. Supportive supervisions done in data quality and management have to be organized in a supportive, and educative way.
May 2018 DOI 10.14302/issn.2381-862X.jwrh-18-2090
Yao Gbagbo FredCorresponding author
University of Education Winneba, Department of Health Administration & Education. P.O. Box 25 Winneba, Ghana.
Background: The Ghanaian culture expects women of reproductive age to reproduce. This makes pregnancy an acceptable occurrence in most tertiary institutions in Ghana. Although Ghanaian Universities allow pregnancy in school, challenges associated with pregnancies do not exempt pregnant students from following the academic requirements of the universities. This study therefore explores students’ experiences of copying with pregnancy in an academic environment in Ghana. Methods: This was a case study, quantitative and qualitative design using structured questionnaires and semi-structured interview guides respectively for data collection. Respondents comprised twenty (30) pregnant full time and part time female students from campuses of University of Education, Winneba. Data collection was between October 2016 and May 2017. Quantitative data were analysed using statistical package for social sciences (SPSS) version 23. The qualitative data was transcribed and manually analysed thematically. Results: The study found that majority of participants were adults between ages 26 and 30 years. More than half of them (66.7%) had no child and this was their first pregnancy which they felt was mistimed as it occurred during schooling, posing some physiological, financial and academic challenges which compelled students to devise various coping strategies to combine academic work and pregnancy amidst limited University provisions for pregnant students. Conclusions: The study results have policy and programme implications for meeting women’s needs for pursuing academic and reproductive goals concurrently. The study recommends that public universities in Ghana should institutionalise programmes on preconception counselling and coping with pregnancy in academic environment to enable female students make informed decisions on exercising their reproductive rights in whilst in the university to ensure positive maternal health outcomes.