Research Article
A Theory of Change to Increase First Trimester Antenatal Care (Anc1) Attendance at Nsiika Health Centre IV, Buhweju District, Uganda
Kennedy Ssejjengo*
,
Isaac Edyedu,
Philip Muhamya,
Caroline Tukamushaba
Issue:
Volume 7, Issue 2, June 2026
Pages:
21-29
Received:
13 January 2026
Accepted:
27 January 2026
Published:
28 May 2026
Abstract: Early initiation of antenatal care (ANC) during the first trimester is a critical determinant of maternal and neonatal health outcomes. However, despite national and World Health Organization recommendations, first-trimester antenatal care (ANC1) attendance remains suboptimal in many rural settings in Uganda. At Nsiika Health Centre IV in Buhweju District, only 62% of pregnant women initiated ANC within the first trimester in 2025, indicating persistent gaps in timely maternal health service utilization. This paper presents a context-specific Theory of Change (ToC) developed to improve first-trimester ANC attendance at Nsiika Health Centre IV by addressing locally relevant socio-cultural, geographical, and health system barriers influencing maternal health-seeking behavior. This study aimed to design a practical, evidence-informed framework to guide district-level interventions for increasing early ANC uptake and improving maternal and neonatal outcomes. The ToC was developed using routine District Health Information Software (DHIS2) data, facility performance reviews, maternal health indicators, and district health priorities. Key barriers identified included delayed pregnancy confirmation, limited community awareness of early ANC benefits, long distances to health facilities, and inadequate community-level follow-up. The proposed framework integrates community-based strategies such as Village Health Team (VHT) engagement, home-based pregnancy screening using human chorionic gonadotropin (HCG) tests, targeted health education, and integrated community outreaches with facility-level interventions focused on improving service readiness, client experience, and continuity of care. The Theory of Change assumes that early identification of pregnancy, strengthened community facility linkages, and improved service responsiveness will lead to timely ANC initiation, increased institutional deliveries, and improved maternal and neonatal outcomes. By tailoring interventions to the Nsiika context, this ToC provides a scalable model for improving early ANC uptake in rural, resource-constrained settings and supports district efforts to increase ANC1 attendance to 95% by 2027.
Abstract: Early initiation of antenatal care (ANC) during the first trimester is a critical determinant of maternal and neonatal health outcomes. However, despite national and World Health Organization recommendations, first-trimester antenatal care (ANC1) attendance remains suboptimal in many rural settings in Uganda. At Nsiika Health Centre IV in Buhweju D...
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Review Article
Review on Milk Production Performance of Dairy Cattle in Ethiopia
Ediris Abdulkadir Meko*
Issue:
Volume 7, Issue 2, June 2026
Pages:
30-37
Received:
16 May 2026
Accepted:
29 May 2026
Published:
18 June 2026
DOI:
10.11648/j.innov.20260702.12
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Abstract: This review paper is aims to overview the Milk Production Performance of Dairy Cattle in Ethiopia to recommend strategic intervention for improving milk production performance that match the population growth and strengthen the contribution of the dairy industry in Ethiopia's national economy. Dairy production systems were categorized into 2 main systems: rural or traditional dairy production system which includes (pastoralists, agro- pastoralists, and mixed crop–livestock producers) and urban and peri-urban dairy systems. In Ethiopia, dairy production is based on subsistence smallholder farmers and most of the production comes from local dairy cattle, which results in low production and productivity and does not meet with the growing demand for milk. To commensurate milk production with the demand local dairy cow breeds are being improved through crossbreeding with exotic breeds. Crossbred dairy cows have more milk production performances than local breeds due to heterosis effect. Indigenous breed cows which produces low milk yield, contributes the main milk production that account for ninety seven percent of the total milk production of Ethiopia. The average lactation length for local breeds is six months, while the average lactation length of exotic breeds is 305 days and results in higher milk yields under intensive management. However, milk production performance of the cows is being affected by poor quality and unaffordable feed resources, animal diseases like mastitis and climatic stresses.
Abstract: This review paper is aims to overview the Milk Production Performance of Dairy Cattle in Ethiopia to recommend strategic intervention for improving milk production performance that match the population growth and strengthen the contribution of the dairy industry in Ethiopia's national economy. Dairy production systems were categorized into 2 main s...
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