Uganda’s poor maternal health indicators have resulted from weak maternal health services delivery, including access to quality family planning, skilled birth attendance, emergency obstetric care, and postnatal care for mothers and newborns. This paper investigated the predictors of maternal health services (MHS) utilization characterized as: desirable, moderate and undesirable. We used a sample of 1728 women of reproductive ages (15–49), who delivered a child a year prior to the 2011 UDHS survey. A multinomial logistic regression model was used to analyze the relative contribution of the various predictors of ideal maternal health services package utilization. Andersen’s Behavioral Model of Health Services Utilization guided the selection of covariates in the regression model. Women with secondary and higher education were more likely to utilize the desirable maternal health care package (RRR = 4.5; 95 % CI = 1.5-14.0), compared to those who had none (reference = undesirable MHS package). Women who lived in regions outside Kampala, Uganda’s capital, were less likely to utilize the desirable package of maternal health services (Eastern – RRR = 0.2, CI = 0.1-0.5; Western – RRR = 0.3, CI = 0.1-0.8; Central – RRR = 0.3, CI = 0.1-0.8; Northern – RRR = 0.4, CI = 0.2-1.0). Women from the richest households were more likely to utilize the desirable maternal health services package (RRR = 1.9; 95 % CI = 1.0-3.7). Residence in rural areas, being Moslem and being married reduced a woman’s chances of utilizing moderate maternal health care services. Utilization of maternal health services varied greatly by demographic and socio-economic characteristics. Women with a secondary and higher education, and those of higher income levels, were more likely to utilize the ideal maternal health services package. Therefore, there is need to formulate policies and design maternal health services programs that target the socially marginalized women.

The rationale for promotion of family planning (FP) to delay conception after a recent birth is a best practice that can lead to optimal maternal and child health outcomes. Uptake of postpartum family planning (PPFP) remains low in sub-Saharan Africa. However, little is known about how pregnant women arrive at their decisions to adopt PPFP. We used 3298 women of reproductive ages 15–49 from the 2011 UDHS dataset, who had a birth in the 5 years preceding the survey. We then applied both descriptive analyses comprising Pearson’s chi-square test and later a binary logistic regression model to analyze the relative contribution of the various predictors of uptake of modern contraceptives during the postpartum period. More than a quarter (28%) of the women used modern family planning during the postpartum period in Uganda. PPFP was significantly associated with primary or higher education (OR=1.96; 95% CI=1.43-2.68; OR=2.73; 95% CI=1.88-3.97 respectively); richest wealth status (OR=2.64; 95% CI=1.81-3.86); protestant religion (OR=1.27; 95% CI=1.05-1.54) and age of woman (OR=0.97, 95% CI=0.95-0.99). In addition, PPFP was associated with number of surviving children (OR=1.09; 95 % CI=1.03-1.16); exposure to media (OR=1.30; 95% CI=1.05-1.61); skilled birth attendance (OR=1.39; 95% CI=1.12-1.17); and 1–2 days timing of post-delivery care (OR=1.68; 95% CI=1.14-2.47). Increasing reproductive health education and information among postpartum women especially those who are disadvantaged, those with no education and the poor would significantly improve PPFP in Uganda.

Background: There is dearth of knowledge and research about the role of empowerment, partners’ behaviours and intimate partner physical violence (IPPV) among married women in Uganda. This paper examined the influence of women’s empowerment and partners’ behaviours on IPPV among married women in Uganda. Methods: The 2011 Uganda Demographic and Health Survey data were used, selecting a weighted sample of 1,307 women in union considered for the domestic violence module. Cross tabulations (chi-square tests) and multivariate logistic regressions were used to identify factors associated with IPPV. Results: The prevalence of IPPV among women in union in Uganda is still high (41%). Women’s occupation was the only measure of empowerment that was significantly associated with IPPV, where women in professional employment were less likely to experience IPPV. Women from wealthy households were less likely to experience IPPV. IPPV was more likely to be reported by women who had ever had children and witnessed parental IPPV. IPPV was also more likely to be reported by women whose husbands or partners: accused them of unfaithfulness, did not permit them to meet female friends, insisted on knowing their whereabouts and sometimes or often got drunk. Women who were afraid their partners were also more likely to report IPPV. Conclusion: In the Ugandan context, women’s empowerment as assessed by the UDHS has limited mitigating effect on IPPV in the face of partners’ negative behaviours and history of witnessing parental violence.

Background: In Uganda, just like in many sub-Saharan countries, studies on Intimate Partner Violence (IPV) among married women are limited. The aim of this paper was to determine the correlates of emotional, sexual, physical IPV and any form of IPV among married women in Uganda. Methods: The 2016 Uganda Demographic and Health Survey (UDHS) data was used, and a weighted sample of 6879 married women were selected from the Domestic Violence module. Frequency distributions were used to describe the characteristics of respondents. Chi-square tests were used to establish the association between IPV and the explanatory variables. Binary logistic regressions were used to establish the factors that were associated with IPV among married women in Uganda. Results: More than half (56%) of the married women experienced some form of IPV. Sexual IPV was the least prevalent (23%) and 4 in 10 women (41 and 40%) experienced physical and emotional IPV, respectively. Factors associated with all the different forms of IPV included, age, region, witnessing parental violence, partner’s controlling behaviors, duration of the relationship, and frequency of intoxication of the male partner. Conclusion: IPV among Ugandan married women is far too common. This calls for collective efforts to reduce IPV in Uganda by addressing excessive alcohol consumption, controlling behaviors, and lack of awareness of the issue. Interventions aimed at preventing perpetration and tolerance of violence in the home settings should be promoted.

Older persons report poor health status and greater need for healthcare. However, there is limited research on older persons’ healthcare disparities in Uganda. Therefore, this paper aimed at investigating factors associated with older persons’ healthcare access in Uganda, using a nationally representative sample. We conducted secondary analysis of data from a sample of 1602 older persons who reported being sick in the last 30 days preceding the Uganda National Household Survey. We used frequency distributions for descriptive data analysis and chi-square tests to identify initial associations. We fit generalized linear models (GLM) with the poisson family and the log link function, to obtain incidence risk ratios (RR) of accessing healthcare in the last 30 days, by older persons in Uganda. More than three quarters (76%) of the older persons accessed healthcare in the last 30 days. Access to healthcare in the last 30 days was reduced for older persons from poor households (RR = 0.91, 95% CI: 0.83-0.99); with some walking difficulty (RR = 0.90, 95% CI: 0.83-0.97); or with a lot of walking difficulty (RR = 0.84, 95% CI: 0.75-0.95). Conversely, accessing healthcare in the last 30 days for older persons increased for those who earned wages (RR = 1.08, 95% CI: 1.00-1.15) and missed work due to illness for 1–7 days (RR = 1.19, 95% CI: 1.10-1.30); and 8–14 days (RR = 1.19, 95% CI: 1.07-1.31). In addition, those who reported non-communicable diseases (NCDs) such as heart disease, hypertension or diabetes (RR = 1.09, 95% CI: 1.01-1.16); were more likely to access healthcare during the last 30 days. In the Ugandan context, health need factors (self-reported NCDs, severity of illness and mobility limitations) and enabling factors (household wealth status and earning wages in particular) were the most important determinants of accessing healthcare in the last 30 days among older persons.

Studies on the association between partners’ controlling behaviors and intimate partner sexual violence (IPSV) in Uganda are limited. The aim of this paper was to investigate the association between IPSV and partners’ controlling behaviors among married women in Uganda. We used the 2011 Uganda Demographic and Health Survey (UDHS) data, and selected a weighted sample of 1,307 women who were in a union, out of those considered for the domestic violence module. We used chi-squared tests and multivariable logistic regressions to investigate the factors associated with IPSV, including partners’ controlling behaviors. More than a quarter (27%) of women who were in a union in Uganda reported IPSV. The odds of reporting IPSV were higher among women whose partners were jealous if they talked with other men (OR = 1.81; 95% CI: 1.22-2.68), if their partners accused them of unfaithfulness (OR = 1.50; 95% CI: 1.03-2.19) and if their partners did not permit them to meet with female friends (OR = 1.63; 95% CI: 1.11-2.39). The odds of IPSV were also higher among women whose partners tried to limit contact with their family (OR = 1.73; 95% CI: 1.11-2.67) and often got drunk (OR = 1.80; 95% CI: 1.15-2.81). Finally, women who were sometimes or often afraid of their partners (OR = 1.78; 95% CI: 1.21-2.60 and OR = 1.56; 95% CI: 1.04-2.40 respectively) were more likely to report IPSV. In Uganda, women’s socio-economic and demographic background and empowerment had no mitigating effect on IPSV in the face of their partners’ dysfunctional behaviors. Interventions addressing IPSV should place more emphasis on reducing partners’ controlling behaviors and the prevention of problem drinking.