Fredrick Makumbi
Biographic Data
| ID | 379998 |
|---|---|
| NAME | Fredrick Makumbi |
| GIVEN NAMES | Fredrick |
| FAMILY NAME | Makumbi |
| SIGNATURE | MAKUMBI F |
| AFFILIATIONS | Makerere University |
| ORCID | 0000-0002-6460-7325 |
| VERIFIED | Yes |
| TOTAL WORKS | 36 |
| TOTAL CITATIONS | 27 |
| AUTHOR COUNT | 36 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 2007 |
| LATEST PUBLICATION YEAR | 2025 |
| H-INDEX | 3 |
Associations between digital financial services and health campaign workers’ perceived satisfaction, motivation and performance in Nigeria
BACKGROUND: Understanding the association between digital payment services and health worker outcomes is critical to improving public health outcomes and optimising health workforce efficiency. This study examined the link between digital payment systems and health campaign workers' perceived satisfaction, motivation and performance in Nigeria. METHODS: A national survey was conducted among 821 polio immunisation workers who participated in campa…
Characterising people who inject drugs, and association with HIV infection
Uganda implements interventions for injection drug use, but significant barriers hinder efforts to effectively reach and support persons who inject drugs (PWID). We describe characteristics of PWID, and associated risk behaviour, to inform the designing of programmes that are tailored to clients’ needs and preferences. A cross-sectional survey (August 23 rd to December 5 th , 2023) in Kampala interviewed 354 PWID (≥18-years) at selected venues(ba…
Assessing the availability and scope of routine data on post-pregnancy family planning
Many low- and middle-income countries (LMICs) include postpartum and postabortion family planning (PPFP/PAFP) in their national family planning (FP) commitments. Understanding what PPFP and PAFP data are available in routine health information systems (HIS) is important, as both county-level and global monitoring increasingly rely on these systems to track service delivery and scale-up, inform program improvements, and support accountability. Thi…
Evaluating Contraceptive Empowerment Among Women and Girls in Sub‐Saharan Africa
This study evaluates the contraceptive empowerment subscale of the Women's and Girls’ Empowerment in Sexual and Reproductive Health (WGE‐SRH) index across seven sub‐Saharan African countries. Using structural equation modeling and logistic regression among population‐based samples of women aged 15–49, we find evidence that the abbreviated eight‐item subscale is a reliable measure of contraceptive empowerment (Cronbach's alpha range: 0.67–0.78), s…
Estimation of cause-specific mortality in Rakai, Uganda, using verbal autopsy 1999-2019
BACKGROUND: There are scant data on the causes of adult deaths in sub-Saharan Africa. We estimated the level and trends in adult mortality, overall and by different causes, in rural Rakai, Uganda, by age, sex, and HIV status. OBJECTIVES: To estimate and analyse adult cause-specific mortality trends in Rakai, Uganda. METHODOLOGY: Mortality information by cause, age, sex, and HIV status was recorded in the Rakai Community Cohort study using verbal …
Use of mobile phones to collect data on Covid-19
During the COVID-19 pandemic lockdown, we deployed a rapid, mobile phone-based survey to assess access and participation rates when using mobile phones to collect data on COVID-19 in Rakai, south-central Uganda. We sampled prior Rakai Community Cohort Study (RCCS) participants based on HIV status using mobile phone contacts. We administered a 30-minute phone-based interview to consenting participants to assess their knowledge about different aspe…
Equity in family planning policies and programs in Uganda
There is lack of a common understanding and definition of equity in FP programs in Uganda. There is need to build consensus on the definitions and measurements of equity with a multidimensional lens to inform clear policy and programming focus on equity in FP programs and outcomes. To improve equitable access to and use of FP services, attention must be paid to addressing implementation, client and policy constraints
Estimating the Social Visibility of Abortions in Uganda and Ethiopia Using the Game of Contacts
Social network–based data collection methods that rely on third‐party reporting have emerged as a promising approach for measuring abortion in restrictive settings. In order for these methods to accurately measure abortion incidence, they must also assess the visibility of abortions within social networks. Failure to do so may result in estimates affected by transmission bias, caused by imperfect knowledge of all abortions within one's social net…
Predictive utility of key family planning indicators on dynamic contraceptive outcomes
BACKGROUND: Many health and demographic surveys routinely collect information on women’s exposure to family planning (FP) messages, counseling on contraceptive side effects, discussions about FP with providers, contraceptive decision-making autonomy, and the desire for additional children. Several studies have shown significant associations with current contraceptive use status from these cross-sectional data. However, the predictive utility of t…
Lived experiences and drivers of induced abortion among women in central Uganda
Although unsafe abortions are preventable, they are one of the leading causes of maternal mortality and morbidity. Despite the serious potential health consequences, there is limited published information about drivers and challenges of obtaining abortions in restrictive settings such as Uganda. This limits efforts to improve programing for preventing unsafe abortion and providing comprehensive post abortion care. This study sought to understand …
Hopes, joys and fears
Uganda applies the World Health Organization threshold of 1,000 copies/ml to determine HIV viral non-suppression. While there is an emerging concern of low-level viraemia (≥50 to
Self-reported abortion experiences in Ethiopia and Uganda, new evidence from cross-sectional community-based surveys
Unsafe abortion is a major contributor to maternal morbidity and mortality. To gain insight into the ways in which abortion restrictions and stigma may shape reproductive health outcomes, we present self-reported data on abortions in Ethiopia and Uganda and compare these findings across the two varying legal contexts. W investigate differences in sociodemographic characteristics by whether or not a woman self-reported an abortion, and we describe…
Menstrual health challenges in the workplace and consequences for women’s work and wellbeing
This study describes women’s menstrual health needs at work in Uganda and explores the associations between unmet needs and women’s work and wellbeing. We undertook a cross-sectional survey of women working in marketplaces, public primary schools, and health care facilities in Mukono district, central Uganda. Survey questions were designed to capture women’s experiences of managing menstrual bleeding, pain, social support, and the social environm…
Cardiovascular (Framingham) and type II diabetes (Finnish Diabetes) risk scores
While most items of the FRS and FINDRISC were generally well understood, physical activity needs further clarification. It is important to consider the seasonality of fruits and vegetables, especially in rural resource-poor settings. Current risk scores will need to be locally adapted to estimate the 10-year risk of cardiovascular diseases and type 2 diabetes in this setting
The Long-term (5-year) Impact of a Family Economic Empowerment Intervention on Adolescents Living with HIV in Uganda
Resumption of Sexual Intercourse Among Postnatal Women Enrolled on Lifelong Antiretroviral Therapy in Uganda
A sexual and reproductive empowerment framework to explore volitional sex in sub-Saharan Africa
Volitional sex is central to the sexual health and well-being of women and girls globally. To date, few studies have examined women's empowerment and its application to sexual health outcomes, including volitional sex. The aim of this study was to explore the relevance of a sexual and reproductive empowerment framework to volitional sex across four geographically and culturally diverse contexts in sub-Saharan Africa. Qualitative data were collect…
A Panel Study of Fertility Preferences and Contraceptive Dynamics in the Presence of Competing Pregnancy Risks in Uganda
Although many studies have examined the influence of women's fertility preferences on subsequent fertility behavior and the role of contraceptive use intentions on unmet need, very few have explored their concurrent effects on contraceptive use dynamics. This study examines the independent concurrent effects of women's fertility preferences and contraceptive intentions on subsequent adoption and discontinuation, treating pregnancy as a competing …
Family Planning Beliefs and Their Association with Contraceptive Use Dynamics
Norms and beliefs toward contraception, both positive and negative, motivate contraceptive use; however, they have seldom been explored longitudinally in low‐ and middle‐income countries, limiting our understanding of their influence on contraceptive dynamics. We used PMA2020 Uganda national longitudinal data of reproductive aged women in 2018 (baseline) and 2019 (follow‐up) to explore discontinuation and switching among modern contraceptive user…
‘ I do what a woman should do’
Menstrual health has received increasing recognition as an essential issue for public health and gender equality. A growing body of research has elucidated adolescent girls’ menstrual needs and informed policy and practice responses. However, the experiences of adult women have received little attention, particularly in the workplace where many spend a significant proportion of their lives. To address this gap, we took a grounded theory approach …
Reconceptualizing Women's and Girls' Empowerment
CONTEXT: Improving women's empowerment is pivotal to public health and development programs; however, inconsistent definitions and lack of cross-cultural measures compromise monitoring efforts. METHODS: Data collected in 2017-2018 in Ethiopia, Uganda and two sites in Nigeria were used to develop a cross-cultural index of women's and girls' empowerment in sexual and reproductive health (WGE-SRH). Item development was grounded in qualitative interv…
Enhancers and barriers to uptake of male circumcision services in Northern Uganda
Uganda adopted voluntary medical male circumcision (VMMC) in 2010, but uptake remains disproportionately low in the Northern region despite implementing several demand creation strategies. This study explored the socio-cultural and structural enhancers and barriers to uptake of VMMC services in Gulu, a district in Northern Uganda where uptake is lowest. In September 2016, we conducted 19 focus group discussions, 9 in-depth interviews, and 11 key …
Covert use of contraception in three sub-Saharan African countries
Results indicate that while covert use of contraception is common, continued covert use is challenging, especially when side effects manifest. Covert use may further suggest women taking independent action, symbolizing some level of empowerment. Results underscore the importance of disentangling unique reasons for covert use and the severity of repercussions of disclosure
Reconceptualizing Measurement of Emergency Contraceptive Use
Estimated use of emergency contraception (EC) remains low, and one reason is measurement challenges. The study aims to compare EC use estimates using five approaches. Data come from Performance Monitoring and Accountability 2020 surveys from 10 countries, representative sample surveys of women aged 15 to 49 years. We explore EC use employing the five definitions and calculate absolute differences between a reference definition (percentage of wome…
I am the master key that opens and locks
The WGE-SRH framework is useful for exploring SRH empowerment, embracing the multilevel, dynamic nature of empowerment, as a process transitioning from existence of choice (autonomy) to exercise of choice (self-efficacy, decision-making, negotiation), and, ultimately, to achievement of choice. Future research and programs related to SRH empowerment should distinguish between existence and exercise of choices to promote the health and well-being o…
I am the master key that opens and locks
The WGE-SRH framework is useful for exploring SRH empowerment, embracing the multilevel, dynamic nature of empowerment, as a process transitioning from existence of choice (autonomy) to exercise of choice (self-efficacy, decision-making, negotiation), and, ultimately, to achievement of choice. Future research and programs related to SRH empowerment should distinguish between existence and exercise of choices to promote the health and well-being o…
Reconceptualizing Measurement of Emergency Contraceptive Use
Estimated use of emergency contraception (EC) remains low, and one reason is measurement challenges. The study aims to compare EC use estimates using five approaches. Data come from Performance Monitoring and Accountability 2020 surveys from 10 countries, representative sample surveys of women aged 15 to 49 years. We explore EC use employing the five definitions and calculate absolute differences between a reference definition (percentage of wome…
Measuring family planning quality and its link with contraceptive use in public facilities in Burkina Faso, Ethiopia, Kenya and Uganda
The individual impacts of several components of family planning service quality on contraceptive use have been studied, but the influence of a composite measure synthesizing these components has not been often investigated. We (1) develop a composite score for family planning service quality based on health facility data from Burkina Faso, Ethiopia, Kenya and Uganda and (2) examine the influence of structural quality on contraceptive practice in …
Family Planning Beliefs and Their Association with Contraceptive Use Dynamics
Norms and beliefs toward contraception, both positive and negative, motivate contraceptive use; however, they have seldom been explored longitudinally in low‐ and middle‐income countries, limiting our understanding of their influence on contraceptive dynamics. We used PMA2020 Uganda national longitudinal data of reproductive aged women in 2018 (baseline) and 2019 (follow‐up) to explore discontinuation and switching among modern contraceptive user…
Sexually Transmitted Infection Management, Safer Sex Promotion and Voluntary HIV Counselling and Testing in the Male Circumcision Trial, Rakai, Uganda
If circumcised men believe that they are protected from HIV there is a possibility that they will compensate for their perceived risk reduction by engaging in higher risk behaviours thereby mitigating any benefit of circumcision in preventing HIV infection. Some observational studies have shown that circumcised men engage in higher risk behaviours than uncircumcised men and the Orange Farm trial in South Africa found circumcised men to have sligh…
Sexually Transmitted Infection Management, Safer Sex Promotion and Voluntary HIV Counselling and Testing in the Male Circumcision Trial, Rakai, Uganda
If circumcised men believe that they are protected from HIV there is a possibility that they will compensate for their perceived risk reduction by engaging in higher risk behaviours thereby mitigating any benefit of circumcision in preventing HIV infection. Some observational studies have shown that circumcised men engage in higher risk behaviours than uncircumcised men and the Orange Farm trial in South Africa found circumcised men to have sligh…
Disclosure of HIV results among discordant couples in Rakai, Uganda
Disclosure of HIV sero-positive results among HIV-discordant couples in sub-Saharan Africa is generally low. We describe a facilitated couple counselling approach to enhance disclosure among HIV-discordant couples. Using unique identifiers, 293 HIV-discordant couples were identified through retrospective linkage of married or cohabiting consenting adults individually enrolled into a cohort study and into two randomised trials of male circumcision…
Non-enrollment for free community HIV care
Improved understanding of HIV-related health-seeking behavior at a population level is important in informing the design of more effective HIV prevention and care strategies. We assessed the frequency and determinants of failure to seek free HIV care in Rakai, Uganda. HIV-positive participants in a community cohort who accepted VCT were referred for free HIV care (cotrimoxazole prophylaxis, CD4 monitoring, treatment of opportunistic infections, a…
Trends in HIV counseling and testing uptake among married individuals in Rakai, Uganda
Uptake of couples' HCT remained consistently low (below 30%) over the years, while uptake of individual HCT declined over time. These findings call for innovative strategies to increase demand for couples' HCT, particularly among younger couples and those with no prior HCT
Knowledge and perceptions of brucellosis in the pastoral communities adjacent to Lake Mburo National Park, Uganda
There was moderate overall knowledge of human and animal brucellosis among the participants. Majority of the participants believed that close proximity to wildlife contributes to the presence of the disease in the area. There is a need for collaboration between the public health, veterinary and wildlife sectors to provide health education on brucellosis for better management of the disease in the communities
A comparison of sexual risk behaviours and HIV seroprevalence among circumcised and uncircumcised men before and after implementation of the safe male circumcision programme in Uganda
There was higher prevalence of SRBs among circumcised men in both surveys, but the only significant change from 2004 to 2011 was a lower prevalence of condom use among the circumcised. Nevertheless, HIV prevalence was lower among circumcised men. Targeted messages for circumcised men and their sexual partners to continue using condoms even after circumcision should be enhanced to avoid risk compensation
Forecast analysis of any opportunistic infection among HIV positive individuals on antiretroviral therapy in Uganda
While the prevalence of any OI among HIV positive individuals on HAART in Uganda is expected to decrease overall, it's unlikely that OIs will be completely eliminated in the foreseeable future. There is therefore need for continued efforts in prevention and control of opportunistic infections in all HIV/AIDS care programmes in these settings
HIV prevalence and uptake of HIV/Aids services among youths (15–24 Years) in fishing and neighboring communities of Kasensero, Rakai District, South Western Uganda
The prevalence of HIV is high especially among young females and in landing site communities than in the peripheral communities. Uptake of HIV prevention and treatment services is very low. There is an urgent need for youth-friendly services in these communities
Measuring family planning quality and its link with contraceptive use in public facilities in Burkina Faso, Ethiopia, Kenya and Uganda
The individual impacts of several components of family planning service quality on contraceptive use have been studied, but the influence of a composite measure synthesizing these components has not been often investigated. We (1) develop a composite score for family planning service quality based on health facility data from Burkina Faso, Ethiopia, Kenya and Uganda and (2) examine the influence of structural quality on contraceptive practice in …
Factors associated with prior engagement in high-risk sexual behaviours among adolescents (10–19 years) in a pastoralist post-conflict community, Karamoja sub-region, North eastern Uganda
Prior engagement in high-risk sexual behaviours was significantly associated with having sex with partners of unknown HIV sero-status and use of illicit drugs. These findings suggest a need for targeted interventions to improve mutual HIV status disclosure between sexual partners while minimizing their use of illicit drugs/substances
Geographical variations of the associations between health interventions and all-cause under-five mortality in Uganda
Sub-national estimates of the associations between U5M and interventions can guide control programmes for spatial targeting and accelerate progress towards mortality-related Sustainable Development Goals
‘ I do what a woman should do’
Menstrual health has received increasing recognition as an essential issue for public health and gender equality. A growing body of research has elucidated adolescent girls’ menstrual needs and informed policy and practice responses. However, the experiences of adult women have received little attention, particularly in the workplace where many spend a significant proportion of their lives. To address this gap, we took a grounded theory approach …
Reconceptualizing Women's and Girls' Empowerment
CONTEXT: Improving women's empowerment is pivotal to public health and development programs; however, inconsistent definitions and lack of cross-cultural measures compromise monitoring efforts. METHODS: Data collected in 2017-2018 in Ethiopia, Uganda and two sites in Nigeria were used to develop a cross-cultural index of women's and girls' empowerment in sexual and reproductive health (WGE-SRH). Item development was grounded in qualitative interv…
Enhancers and barriers to uptake of male circumcision services in Northern Uganda
Uganda adopted voluntary medical male circumcision (VMMC) in 2010, but uptake remains disproportionately low in the Northern region despite implementing several demand creation strategies. This study explored the socio-cultural and structural enhancers and barriers to uptake of VMMC services in Gulu, a district in Northern Uganda where uptake is lowest. In September 2016, we conducted 19 focus group discussions, 9 in-depth interviews, and 11 key …
Covert use of contraception in three sub-Saharan African countries
Results indicate that while covert use of contraception is common, continued covert use is challenging, especially when side effects manifest. Covert use may further suggest women taking independent action, symbolizing some level of empowerment. Results underscore the importance of disentangling unique reasons for covert use and the severity of repercussions of disclosure
Reconceptualizing Measurement of Emergency Contraceptive Use
Estimated use of emergency contraception (EC) remains low, and one reason is measurement challenges. The study aims to compare EC use estimates using five approaches. Data come from Performance Monitoring and Accountability 2020 surveys from 10 countries, representative sample surveys of women aged 15 to 49 years. We explore EC use employing the five definitions and calculate absolute differences between a reference definition (percentage of wome…
I am the master key that opens and locks
The WGE-SRH framework is useful for exploring SRH empowerment, embracing the multilevel, dynamic nature of empowerment, as a process transitioning from existence of choice (autonomy) to exercise of choice (self-efficacy, decision-making, negotiation), and, ultimately, to achievement of choice. Future research and programs related to SRH empowerment should distinguish between existence and exercise of choices to promote the health and well-being o…
Resumption of Sexual Intercourse Among Postnatal Women Enrolled on Lifelong Antiretroviral Therapy in Uganda
A sexual and reproductive empowerment framework to explore volitional sex in sub-Saharan Africa
Volitional sex is central to the sexual health and well-being of women and girls globally. To date, few studies have examined women's empowerment and its application to sexual health outcomes, including volitional sex. The aim of this study was to explore the relevance of a sexual and reproductive empowerment framework to volitional sex across four geographically and culturally diverse contexts in sub-Saharan Africa. Qualitative data were collect…
A Panel Study of Fertility Preferences and Contraceptive Dynamics in the Presence of Competing Pregnancy Risks in Uganda
Although many studies have examined the influence of women's fertility preferences on subsequent fertility behavior and the role of contraceptive use intentions on unmet need, very few have explored their concurrent effects on contraceptive use dynamics. This study examines the independent concurrent effects of women's fertility preferences and contraceptive intentions on subsequent adoption and discontinuation, treating pregnancy as a competing …
Family Planning Beliefs and Their Association with Contraceptive Use Dynamics
Norms and beliefs toward contraception, both positive and negative, motivate contraceptive use; however, they have seldom been explored longitudinally in low‐ and middle‐income countries, limiting our understanding of their influence on contraceptive dynamics. We used PMA2020 Uganda national longitudinal data of reproductive aged women in 2018 (baseline) and 2019 (follow‐up) to explore discontinuation and switching among modern contraceptive user…
Menstrual health challenges in the workplace and consequences for women’s work and wellbeing
This study describes women’s menstrual health needs at work in Uganda and explores the associations between unmet needs and women’s work and wellbeing. We undertook a cross-sectional survey of women working in marketplaces, public primary schools, and health care facilities in Mukono district, central Uganda. Survey questions were designed to capture women’s experiences of managing menstrual bleeding, pain, social support, and the social environm…
Cardiovascular (Framingham) and type II diabetes (Finnish Diabetes) risk scores
While most items of the FRS and FINDRISC were generally well understood, physical activity needs further clarification. It is important to consider the seasonality of fruits and vegetables, especially in rural resource-poor settings. Current risk scores will need to be locally adapted to estimate the 10-year risk of cardiovascular diseases and type 2 diabetes in this setting
The Long-term (5-year) Impact of a Family Economic Empowerment Intervention on Adolescents Living with HIV in Uganda
Lived experiences and drivers of induced abortion among women in central Uganda
Although unsafe abortions are preventable, they are one of the leading causes of maternal mortality and morbidity. Despite the serious potential health consequences, there is limited published information about drivers and challenges of obtaining abortions in restrictive settings such as Uganda. This limits efforts to improve programing for preventing unsafe abortion and providing comprehensive post abortion care. This study sought to understand …
Medicine (30 works) · Demography (22 works) · Environmental health (20 works) · Adolescent Sexual and Reproductive Health (17 works) · Population (17 works) · Global Maternal and Child Health (15 works) · Demography (14 works) · Sociology (14 works) · HIV/AIDS Research and Interventions (12 works) · Psychology (12 works)