Rornald Muhumuza Kananura
Biographic Data
| ID | 6331446 |
|---|---|
| NAME | Rornald Muhumuza Kananura |
| GIVEN NAMES | Rornald Muhumuza |
| FAMILY NAME | Kananura |
| SIGNATURE | KANANURA R M |
| AFFILIATIONS | Makerere University |
| ORCID | 0000-0002-9915-1989 |
| VERIFIED | Yes |
| TOTAL WORKS | 30 |
| TOTAL CITATIONS | 5 |
| AUTHOR COUNT | 30 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 2017 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 1 |
Understanding drivers of neonatal mortality in Zimbabwe
In Zimbabwe, the neonatal mortality rate (NMR) is higher than the regional average, and the country is not on track to reach the Sustainable Development Goal of reducing the NMR by 2030. While other child mortality indicators have improved, NMR has increased. Using machine learning, we aimed to identify the key predictors of neonatal mortality in Zimbabwe. Pooled secondary data analysis of three rounds of the Zimbabwe Demographic Health Survey (Z…
Stillbirth and newborn data quality and use and related input and process factors
Background: The reduction of preventable newborn deaths in low- and middle-income countries is a global priority. The availability of high-quality newborn and stillbirth data is essential for shaping action-oriented policies and interventions towards resolving these challenges. Using a mixed-methods approach, we evaluated the input and process factors hindering data quality and use in Uganda. Methods: We conducted a cross-sectional study from Nov…
Development of a multidimensional deprivation index for emerging municipalities and cities in Uganda
This study advances the measurement of urban living standards deprivation by developing a context-specific multidimensional deprivation index and estimating the extent of deprivation in Uganda’s newly gazetted municipalities and cities. The analysis draws on household listing data collected in November 2021 from 5987 households in Jinja City and Iganga Municipality. Exploratory and confirmatory factor analyses were used to identify latent depriva…
Maternal and child healthcare coverage and trends
Novel approach - leveraging routine facility data, revealed MCH coverage was modestly consistently higher in RH districts over the years and RH status influenced ANC4 coverage. Overall district-CCI depended on Government investment and health systems performance implying increase in PHC financing could be a key driver to universal district-level improvement
Facility newborn and stillbirth data use and enabling factors at different levels of the health system
Background: Improving data quality and use is a priority identified by the World Health Organization (WHO) to reduce stillbirths and newborn deaths; however, few studies have documented newborn and stillbirth data use in the African Region. To address this gap, we conducted a cross-sectional study from November 2022 to July 2024 in 12 regions and four city administrations across the Central African Republic (CAR), Ethiopia, Tanzania, and Uganda. …
Users’ capabilities related to the electronic RHIS for newborn and stillbirth indicators
Background: The electronic routine health information system (eRHIS) is crucial for policy and planning. However, its effectiveness depends on end-users' capabilities in utilising it. Using a mixed-methods approach, we evaluated end-users' data in the Central African Republic (CAR), Ethiopia, Tanzania, and Uganda in one of the first standardised cross-country assessment of eRHIS users' capabilities focussed on newborn and stillbirth indicators. M…
Organisational and management factors and related end-users’ perspectives relevant to newborn and stillbirth data at different levels of the health system
Background: As few studies systematically analysed organisational and management factors related to newborn and stillbirth data quality, we sought to identify specific gaps in these factors to provide evidence for planning tailored actions. Methods: We performed a cross-sectional survey in 12 regions and 4 city administrations in the Central African Republic (CAR), Ethiopia, Tanzania, and Uganda between November 2022 and July 2024, collecting dat…
Availability and the quality of key newborn data within routine health facility data
Background: With declining funding for population-based household surveys, routine health facility data offer a promising alternative for tracking newborn health and service quality. However, their utility depends on data quality. We assessed the quality of ten data elements within routine health information systems in the Central African Republic (CAR), Ethiopia, Tanzania, and Uganda, seven of which align with the Every Newborn Action Plan core …
Data science and artificial intelligence for maternal, newborn and child health
The limited application of data science and artificial intelligence in MNCH at the national level highlights a significant gap in Africa. Our review found that 28 studies (53.8%) were research projects compared to operational implementations integrated into routine systems to inform policy. Main barriers include inadequate infrastructure, limited data stewardship capacity, and insufficient government commitment. Opportunities exist through Africa…
Unmasking the complexities of healthcare access in low-resource settings
BACKGROUND: Access to appropriate obstetric and under-5 healthcare services in low-resource settings is a challenge in countries with high mortality rates. However, the interplay of multiple factors within an ecological system affects the effectiveness of the health system in reaching those in need. OBJECTIVE: This study examined how multiple factors concurrently affect access to obstetric and child healthcare services in resource-poor settings. …
Equity in vaccine coverage in Uganda from 2000 to 2016
The past two decades have seen significant improvements in vaccine coverage and equity, thanks to the efforts to strengthen routine immunization and ongoing supplemental immunization activities such as the Family Health Days. While maintaining the regular provision of vaccines to all regions, efforts should be made to alleviate the impact of low maternal education and literacy on vaccination uptake
Deprivation and Its Association with Child Health and Nutrition in the Greater Kampala Metropolitan Area of Uganda
African cities are experiencing increasing living standard disparities with limited evidence of intra-urban health disparities. Using data from the 2006-2016 Uganda Demographic and Health Surveys, we employed the UN-Habitat definition to examine slum-like household conditions in the Greater Kampala Metropolitan Area (GKMA). Subsequently, we developed a slum-like severity index and assessed its association with under-5 common morbidities and healt…
How a co-design process led to more contextually relevant family planning interventions in emerging urban settings in Eastern Uganda
Voluntary, rights-based family planning upholds women’s right to determine freely the number and spacing of their children. However, low-resource settings like Uganda still face a high unmet need for family planning. And, while urban areas are often indicated to have better access to health services, emerging evidence is revealing intra-urban socio-economic differentials in family planning utilization. To address the barriers to contraceptive use…
Spatial variation and attributable risk factors of anaemia among young children in Uganda
Anaemia continues to be a burden especially in developing countries that not only affects the physical growth and cognitive development of children but also increases their risk to death. Over the past decade, the prevalence of anaemia among Ugandan children has been unacceptably high. Despite this, spatial variation and attributable risk factors of anaemia are not well explored at national level. The study utilized the 2016 Uganda Demographic an…
Health service utilisation during the Covid-19 pandemic in sub-Saharan Africa in 2020
INTRODUCTION: There are concerns about the impact of the COVID-19 pandemic on the continuation of essential health services in sub-Saharan Africa. Through the Countdown to 2030 for Women's, Children's and Adolescents' Health country collaborations, analysts from country and global public health institutions and ministries of health assessed the trends in selected services for maternal, newborn and child health, general service utilisation. METHOD…
Machine learning predictive modelling for identification of predictors of acute respiratory infection and diarrhoea in Uganda’s rural and urban settings
Despite the widely known preventive interventions, the dyad of acute respiratory infections (ARI) and diarrhoea remain among the top global causes of mortality in under– 5 years. Studies on child morbidity have enormously applied “traditional” statistical techniques that have limitations in handling high dimension data, which leads to the exclusion of some variables. Machine Learning (ML) models appear to perform better on high dimension data (da…
Effect of community-level intervention on antenatal care attendance
BACKGROUND: Early Initiation of antenatal care (ANC) and at least four visits during pregnancy allow screening and support for a healthy lifestyle and self-care during pregnancy however, community-directed interventions to improve access to these services are rarely explored. OBJECTIVE: To assess the effect of community health worker (CHW) involvement on utilisation of antenatal services during pregnancy in resource-constrained rural settings in …
Child health and the implementation of Community and District-management Empowerment for Scale-up (Codes) in Uganda
INTRODUCTION: Uganda's district-level administrative units buttress the public healthcare system. In many districts, however, local capacity is incommensurate with that required to plan and implement quality health interventions. This study investigates how a district management strategy informed by local data and community dialogue influences health services. METHODS: A 3-year randomised controlled trial (RCT) comprised of 16 Ugandan districts t…
Does economic growth reduce childhood stunting? A multicountry analysis of 89 Demographic and Health Surveys in sub-Saharan Africa
Background: There is mixed evidence and lack of consensus on the impact of economic development on stunting, and likewise there is a dearth of empirical studies on this relationship in the case of sub-Saharan Africa. Thus, this paper examines whether economic growth is associated with childhood stunting in low-income and middle-income sub-Saharan African countries. Methods: We analysed data from 89 Demographic and Health Surveys conducted between…
Applying the model of diffusion of innovations to understand facilitators for the implementation of maternal and neonatal health programmes in rural Uganda
In Uganda, more than 336 out of every 100,000 women die annually during childbirth. Pregnant women, particularly in rural areas, often lack the financial resources and means to access health facilities in a timely manner for quality antenatal, delivery, and post-natal services. For nearly the past decade, the Makerere University School of Public Health researchers, through various projects, have been spearheading innovative interventions, embedde…
Balancing the cost of leaving with the cost of living
BACKGROUND: Health worker retention in rural and underserved areas remains a persisting problem in many low and middle income countries, and this directly affects the quality of health services offered. OBJECTIVE: This paper explores the drivers of long-term retention and describes health worker coping mechanisms in rural Uganda. METHODS: A descriptive qualitative study explored the factors that motivated health workers to stay, in three rural di…
Characteristics of community savings groups in rural Eastern Uganda
BACKGROUND: Rural populations in Uganda have limited access to formal financial Institutions, but a growing majority belong to saving groups. These saving groups could have the potential to improve household income and access to health services. OBJECTIVE: To understand organizational characteristics, benefits and challenges, of savings groups in rural Uganda. METHODS: This was a cross-sectional descriptive study that employed both quantitative a…
Effect of support supervision on maternal and newborn health services and practices in Rural Eastern Uganda
BACKGROUND: Support supervision is one of the strategies used to check the quality of services provided at health facilities. From 2013 to 2015, Makerere University School of Public Health strengthened support supervision in the district of Kibuku, Kamuli and Pallisa in Eastern Uganda to improve the quality of maternal and newborn services. OBJECTIVE: This article assesses quality improvements in maternal and newborn care services and practices d…
A cascade model of mentorship for frontline health workers in rural health facilities in Eastern Uganda
BACKGROUND: There is increasing demand for trainers to shift from traditional didactic training to innovative approaches that are more results-oriented. Mentorship is one such approach that could bridge the clinical knowledge gap among health workers. OBJECTIVES: This paper describes the experiences of an attempt to improve health-worker performance in maternal and newborn health in three rural districts through a mentoring process using the casc…
Effect of a participatory multisectoral maternal and newborn intervention on birth preparedness and knowledge of maternal and newborn danger signs among women in Eastern Uganda
BACKGROUND: Knowledge of obstetric danger signs and adequate birth preparedness (BP) are critical for improving maternal services utilization. OBJECTIVES: This study assessed the effect of a participatory multi-sectoral maternal and newborn intervention on BP and knowledge of obstetric danger signs among women in Eastern Uganda. METHODS: The Maternal and Neonatal Implementation for Equitable Systems (MANIFEST) study was implemented in three distr…
Gender dynamics affecting maternal health and health care access and use in Uganda
Despite its reduction over the last decade, the maternal mortality rate in Uganda remains high, due to in part a lack of access to maternal health care. In an effort to increase access to care, a quasi-experimental trial using vouchers was implemented in Eastern Uganda between 2009 and 2011. Findings from the trial reported a dramatic increase in pregnant women's access to institutional delivery. Sustainability of such interventions, however, is …
Balancing the cost of leaving with the cost of living
BACKGROUND: Health worker retention in rural and underserved areas remains a persisting problem in many low and middle income countries, and this directly affects the quality of health services offered. OBJECTIVE: This paper explores the drivers of long-term retention and describes health worker coping mechanisms in rural Uganda. METHODS: A descriptive qualitative study explored the factors that motivated health workers to stay, in three rural di…
Characteristics of community savings groups in rural Eastern Uganda
BACKGROUND: Rural populations in Uganda have limited access to formal financial Institutions, but a growing majority belong to saving groups. These saving groups could have the potential to improve household income and access to health services. OBJECTIVE: To understand organizational characteristics, benefits and challenges, of savings groups in rural Uganda. METHODS: This was a cross-sectional descriptive study that employed both quantitative a…
Effect of support supervision on maternal and newborn health services and practices in Rural Eastern Uganda
BACKGROUND: Support supervision is one of the strategies used to check the quality of services provided at health facilities. From 2013 to 2015, Makerere University School of Public Health strengthened support supervision in the district of Kibuku, Kamuli and Pallisa in Eastern Uganda to improve the quality of maternal and newborn services. OBJECTIVE: This article assesses quality improvements in maternal and newborn care services and practices d…
A cascade model of mentorship for frontline health workers in rural health facilities in Eastern Uganda
BACKGROUND: There is increasing demand for trainers to shift from traditional didactic training to innovative approaches that are more results-oriented. Mentorship is one such approach that could bridge the clinical knowledge gap among health workers. OBJECTIVES: This paper describes the experiences of an attempt to improve health-worker performance in maternal and newborn health in three rural districts through a mentoring process using the casc…
Effect of a participatory multisectoral maternal and newborn intervention on birth preparedness and knowledge of maternal and newborn danger signs among women in Eastern Uganda
BACKGROUND: Knowledge of obstetric danger signs and adequate birth preparedness (BP) are critical for improving maternal services utilization. OBJECTIVES: This study assessed the effect of a participatory multi-sectoral maternal and newborn intervention on BP and knowledge of obstetric danger signs among women in Eastern Uganda. METHODS: The Maternal and Neonatal Implementation for Equitable Systems (MANIFEST) study was implemented in three distr…
Working with community health workers to improve maternal and newborn health outcomes
BACKGROUND: Preventable maternal and newborn deaths can be averted through simple evidence-based interventions, such as the use of community health workers (CHWs), also known in Uganda as village health teams. However, the CHW strategy faces implementation challenges regarding training packages, supervision, and motivation. OBJECTIVES: This paper explores knowledge levels of CHWs, describes the coverage of home visits, and shares lessons learnt f…
Effect of a participatory multisectoral maternal and newborn intervention on maternal health service utilization and newborn care practices
BACKGROUND: The MANIFEST study in eastern Uganda employed a participatory multisectoral approach to reduce barriers to access to maternal and newborn care services. OBJECTIVES: This study analyses the effect of the intervention on the utilization of maternal and newborn services and care practices. METHODS: The quasi-experimental pre- and post-comparison design had two main components: community mobilization and empowerment, and health provider c…
Maternal and neonatal implementation for equitable systems. A study design paper
BACKGROUND: Evidence on effective ways of improving maternal and neonatal health outcomes is widely available. The challenge that most low-income countries grapple with is implementation at scale and sustainability. OBJECTIVES: The study aimed at improving access to quality maternal and neonatal health services in a sustainable manner by using a participatory action research approach. METHODS: The study consisted of a quasi-experimental design, w…
‘Nurture the sprouting bud; do not uproot it’ . Using saving groups to save for maternal and newborn health
BACKGROUND: Saving groups are increasingly being used to save in many developing countries. However, there is limited literature about how they can be exploited to improve maternal and newborn health. OBJECTIVES: This paper describes saving practices, factors that encourage and constrain saving with saving groups, and lessons learnt while supporting communities to save through saving groups. METHODS: This qualitative study was done in three distr…
Gender dynamics affecting maternal health and health care access and use in Uganda
Despite its reduction over the last decade, the maternal mortality rate in Uganda remains high, due to in part a lack of access to maternal health care. In an effort to increase access to care, a quasi-experimental trial using vouchers was implemented in Eastern Uganda between 2009 and 2011. Findings from the trial reported a dramatic increase in pregnant women's access to institutional delivery. Sustainability of such interventions, however, is …
Applying the model of diffusion of innovations to understand facilitators for the implementation of maternal and neonatal health programmes in rural Uganda
In Uganda, more than 336 out of every 100,000 women die annually during childbirth. Pregnant women, particularly in rural areas, often lack the financial resources and means to access health facilities in a timely manner for quality antenatal, delivery, and post-natal services. For nearly the past decade, the Makerere University School of Public Health researchers, through various projects, have been spearheading innovative interventions, embedde…
Does economic growth reduce childhood stunting? A multicountry analysis of 89 Demographic and Health Surveys in sub-Saharan Africa
Background: There is mixed evidence and lack of consensus on the impact of economic development on stunting, and likewise there is a dearth of empirical studies on this relationship in the case of sub-Saharan Africa. Thus, this paper examines whether economic growth is associated with childhood stunting in low-income and middle-income sub-Saharan African countries. Methods: We analysed data from 89 Demographic and Health Surveys conducted between…
Child health and the implementation of Community and District-management Empowerment for Scale-up (Codes) in Uganda
INTRODUCTION: Uganda's district-level administrative units buttress the public healthcare system. In many districts, however, local capacity is incommensurate with that required to plan and implement quality health interventions. This study investigates how a district management strategy informed by local data and community dialogue influences health services. METHODS: A 3-year randomised controlled trial (RCT) comprised of 16 Ugandan districts t…
Health service utilisation during the Covid-19 pandemic in sub-Saharan Africa in 2020
INTRODUCTION: There are concerns about the impact of the COVID-19 pandemic on the continuation of essential health services in sub-Saharan Africa. Through the Countdown to 2030 for Women's, Children's and Adolescents' Health country collaborations, analysts from country and global public health institutions and ministries of health assessed the trends in selected services for maternal, newborn and child health, general service utilisation. METHOD…
Machine learning predictive modelling for identification of predictors of acute respiratory infection and diarrhoea in Uganda’s rural and urban settings
Despite the widely known preventive interventions, the dyad of acute respiratory infections (ARI) and diarrhoea remain among the top global causes of mortality in under– 5 years. Studies on child morbidity have enormously applied “traditional” statistical techniques that have limitations in handling high dimension data, which leads to the exclusion of some variables. Machine Learning (ML) models appear to perform better on high dimension data (da…
Effect of community-level intervention on antenatal care attendance
BACKGROUND: Early Initiation of antenatal care (ANC) and at least four visits during pregnancy allow screening and support for a healthy lifestyle and self-care during pregnancy however, community-directed interventions to improve access to these services are rarely explored. OBJECTIVE: To assess the effect of community health worker (CHW) involvement on utilisation of antenatal services during pregnancy in resource-constrained rural settings in …
How a co-design process led to more contextually relevant family planning interventions in emerging urban settings in Eastern Uganda
Voluntary, rights-based family planning upholds women’s right to determine freely the number and spacing of their children. However, low-resource settings like Uganda still face a high unmet need for family planning. And, while urban areas are often indicated to have better access to health services, emerging evidence is revealing intra-urban socio-economic differentials in family planning utilization. To address the barriers to contraceptive use…
Spatial variation and attributable risk factors of anaemia among young children in Uganda
Anaemia continues to be a burden especially in developing countries that not only affects the physical growth and cognitive development of children but also increases their risk to death. Over the past decade, the prevalence of anaemia among Ugandan children has been unacceptably high. Despite this, spatial variation and attributable risk factors of anaemia are not well explored at national level. The study utilized the 2016 Uganda Demographic an…
Unmasking the complexities of healthcare access in low-resource settings
BACKGROUND: Access to appropriate obstetric and under-5 healthcare services in low-resource settings is a challenge in countries with high mortality rates. However, the interplay of multiple factors within an ecological system affects the effectiveness of the health system in reaching those in need. OBJECTIVE: This study examined how multiple factors concurrently affect access to obstetric and child healthcare services in resource-poor settings. …
Equity in vaccine coverage in Uganda from 2000 to 2016
The past two decades have seen significant improvements in vaccine coverage and equity, thanks to the efforts to strengthen routine immunization and ongoing supplemental immunization activities such as the Family Health Days. While maintaining the regular provision of vaccines to all regions, efforts should be made to alleviate the impact of low maternal education and literacy on vaccination uptake
Deprivation and Its Association with Child Health and Nutrition in the Greater Kampala Metropolitan Area of Uganda
African cities are experiencing increasing living standard disparities with limited evidence of intra-urban health disparities. Using data from the 2006-2016 Uganda Demographic and Health Surveys, we employed the UN-Habitat definition to examine slum-like household conditions in the Greater Kampala Metropolitan Area (GKMA). Subsequently, we developed a slum-like severity index and assessed its association with under-5 common morbidities and healt…
Facility newborn and stillbirth data use and enabling factors at different levels of the health system
Background: Improving data quality and use is a priority identified by the World Health Organization (WHO) to reduce stillbirths and newborn deaths; however, few studies have documented newborn and stillbirth data use in the African Region. To address this gap, we conducted a cross-sectional study from November 2022 to July 2024 in 12 regions and four city administrations across the Central African Republic (CAR), Ethiopia, Tanzania, and Uganda. …
Users’ capabilities related to the electronic RHIS for newborn and stillbirth indicators
Background: The electronic routine health information system (eRHIS) is crucial for policy and planning. However, its effectiveness depends on end-users' capabilities in utilising it. Using a mixed-methods approach, we evaluated end-users' data in the Central African Republic (CAR), Ethiopia, Tanzania, and Uganda in one of the first standardised cross-country assessment of eRHIS users' capabilities focussed on newborn and stillbirth indicators. M…
Organisational and management factors and related end-users’ perspectives relevant to newborn and stillbirth data at different levels of the health system
Background: As few studies systematically analysed organisational and management factors related to newborn and stillbirth data quality, we sought to identify specific gaps in these factors to provide evidence for planning tailored actions. Methods: We performed a cross-sectional survey in 12 regions and 4 city administrations in the Central African Republic (CAR), Ethiopia, Tanzania, and Uganda between November 2022 and July 2024, collecting dat…
Availability and the quality of key newborn data within routine health facility data
Background: With declining funding for population-based household surveys, routine health facility data offer a promising alternative for tracking newborn health and service quality. However, their utility depends on data quality. We assessed the quality of ten data elements within routine health information systems in the Central African Republic (CAR), Ethiopia, Tanzania, and Uganda, seven of which align with the Every Newborn Action Plan core …
Global Maternal and Child Health (26 works) · Medicine (21 works) · Environmental health (19 works) · Population (17 works) · Health services (12 works) · Economic growth (11 works) · Nursing (11 works) · Child Nutrition and Water Access (10 works) · Health care (10 works) · Economics (9 works)