Browsing by Subject "Intention"

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    Open Access
    Adolescents' experiences of care during childbirth in health facilities in rural Northern Uganda: a mixed-methods study
    (2025) Udho, Samson; Clow, Sheila
    Background: Despite the importance of care experience during childbirth, there is a dearth of literature on adolescents' experiences of care during childbirth and how their experiences influence their satisfaction with care and future utilization of healthcare facilities. This study examined adolescents' perceptions of PCMC during childbirth in health facilities in rural northern Uganda and how their perceptions influenced their satisfaction with care and future childbearing intentions (intentions to give birth, give birth in the same facility, and recommend the same facility to a sister or friend), and explored the drivers of adolescents' experiences of care during childbirth. Methods: A mixed-methods study was conducted among 570 adolescents aged 14 to 19 years who gave birth in public health facilities in northern Uganda. Adolescents' perceptions of PCMC were measured using the PCMC tool, satisfaction with care was measured using the Six Simple Questions tool, and future childbearing intention was measured using questions from the Community Survey tool. Qualitative data was collected from 14 purposively sampled participants using in-depth interviews. Quantitative data were analysed using descriptive and regression analyses, while qualitative data were analysed thematically and integrated with quantitative data. Results: The PCMC percentage mean score out of 100% was 62% (SD ± 10.12), and percentage mean scores for sub-scales of dignity and respect was 60% (SD ± 12.05), 59% (SD ± 17.12) for communication and autonomy, and 63% (SD ± 9.92) for supportive care. Adolescents' perceptions of moderate/high PCMC during childbirth were positively associated with being married (AOR = 2.61, 95% CI: [1.01, 6.76]), doing casual labour (AOR = 3.18, 95% CI: [1.52, 6.68]), and having an episiotomy (AOR = 1.88, 95% CI: [1.05, 3.36]). Conversely, five to seven antenatal visits (AOR = 0.52, 95% CI: [0.33, 0.83]), birth companionship (AOR = 0.34, 95% CI: [0.19, 0.60]) and having a newborn with complications (AOR = 0.25, 95% CI: [0.09,0.68]) were negatively associated. The mean satisfaction with the care score was 30.12/42 (SD ± 4.10). Adolescents perceived moderate and high levels of PCMC during childbirth were positively associated with satisfaction with care (β = 4.01, 95% CI [3.14, 4.88], p < 0.001and β = 4.38, 95% CI [2.91, 5.86], p < 0.001 respectively). Most adolescents expressed intentions to have another child (82%), return to the same facility for future childbirth (83%), and recommend the same facility to a sister or friend (85%). Adolescents perceived moderate and high levels of PCMC during childbirth were positively associated with intentions to choose the same facility for the next childbirth (AOR=2.84, 95% CI [1.61, 5.00] and AOR=5.60, 95% CI [1.19, 26.43] respectively) and recommend the facility to a sister or friend (AOR=4.31, 95% CI [2.46, 7.54]). Adolescents had mixed experiences during childbirth, ranging from positive experiences of effective communication, dignity and respect, supportive care, and health facility hygiene to negative experiences of disrespect and abuse, and health facility constraints. Negative experiences were associated with lack of birthing necessities, younger age, and perceived low social status while positive experiences were driven by passive compliance, calm demeanor, relational skills, possession of birthing necessities, cleanliness, and smartness. Conclusion: Adolescents' varied experiences of care during childbirth, influenced by various individual-level factors, resulted in perceptions of moderate PCMC during childbirth. PCMC has the potential to enhance childbirth experience for adolescent mothers, as well as influence their satisfaction with care and future childbearing intentions.
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    Open Access
    Perceptions of body size, obesity threat and the willingness to lose weight among black South African adults: a qualitative study
    (2016) Okop, Kufre Joseph; Mukumbang, Ferdinand C; Mathole, Thubelihle; Levitt, Naomi; Puoane, Thandi
    Abstract Background The obesity epidemic is associated with rising rates of cardiovascular disease (CVD) among adults, particularly in countries undergoing rapid urbanisation and nutrition transition. This study explored the perceptions of body size, obesity risk awareness, and the willingness to lose weight among adults in a resource-limited urban community to inform appropriate community-based interventions for the prevention of obesity. Method This is a descriptive qualitative study. Semi-structured focus group discussions were conducted with purposively selected black men and women aged 35–70 years living in an urban South African township. Weight and height measurements were taken, and the participants were classified into optimal weight, overweight and obese groups based on their body mass index (Kg/m 2 ). Participants were asked to discuss on perceived obesity threat and risk of cardiovascular disease. Information on body image perceptions and the willingness to lose excess body weight were also discussed. Discussions were conducted in the local language (isiXhosa), transcribed and translated into English. Data was analysed using the thematic analysis approach. Results Participants generally believed that obesity could lead to health conditions such as heart attack, stroke, diabetes, and hypertension. However, severity of obesity was perceived differently in the groups. Men in all groups and women in the obese and optimal weight groups perceived obesity to be a serious threat to their health, whereas the overweight women did not. Obese participants who had experienced chronic disease conditions indicated strong perceptions of risk of obesity and cardiovascular disease. Obese participants, particularly men, expressed willingness to lose weight, compared to the men and women who were overweight. The belief that overweight is ‘normal’ and not a disease, subjective norms, and inaccessibility to physical activity facilities, negatively influenced participants’ readiness to lose weight. Conclusion Low perception of threat of obesity to health particularly among overweight women in this community indicates a considerable challenge to obesity control. Community health education and promotion programmes that increase awareness about the risk associated with overweight, and improve the motivation for physical activity and maintenance of optimal body weight are needed.