27 research outputs found
Quality of health care in Mukono District
No full textA dissertation submitted in partial fulfillment of the requirements for the award of the degree of Master of Public Health of Makerere UniversityThere is no reliable information on the quality of care offered in health units in Mukono District. This study was therefore carried out to provide the DHT with information for targeting improvements in quality of care. The study objectives were to, i) assess patient satisfaction with quality of care provided in health units in Mukono District, ii) assess the quality of the process of health care delivery in health units in Mukono District, iii) assess health care provider prescribing behavior using treatment of malaria in children under five years as a proxy indicator, and iv) determine factors that influence delivery of quality health care among health care providers in Mukono District. A descriptive cross sectional study was done. A stratified sample of eighteen health units was selected. Three hundred and eighty seven patients were interviewed to assess satisfaction with the quality of health care. To assess the process of health care delivery, 18 health care providers were observed attending to three sick under five year old children each. Health care provider prescribing behavior was assessed retrospectively by a review of records of malaria treatment in children under five years old. Three hundred and eighty four records of previous six months were reviewed. Factors affecting delivery of quality care by health care providers was assessed by use of key informant interviews. The results on patient satisfaction revealed that 15.5% (60/387) of patient respondents were completely satisfied with the overall quality of care provided in the health units. Eighty percent (311/387) were satisfied, 4% (14/387) were dissatisfied and 0.5% (2/387) were completely dissatisfied. The quality of the process of care was assessed using a scoring system. At a cut off mark of 60% of the expected total score, only 35.2% of the children were managed adequately. This study also found that on average, 3.2 drugs were dispensed to each child with malaria and 41.8% received antibiotics. Eighty five percent received an injection and only 48.3% were treated according to NSTG. The key informants thought that factors that contribute to quality health care were availability of drugs and equipment, adequate staffing with trained personnel, regular effective support supervision, and motivation of health care providers. From the findings of this study, it may be concluded that patients are generally satisfied with the quality of health care provided in the health units of Mukono District. However technical competence of health care providers does not reach required standards. It is therefore recommended that the DHT of Mukono District focus training of health care providers on clinical case management of common childhood illnesses and rational drug use
Quality of health care in Mukono District
No full textA thesis submitted in partial fulfillment of the requirements for the award of the Masters of Medicine Degree in Public Health of Makerere University.There is no reliable information on the quality of care offered in health units in Mukono District. This study was therefore carried out to provide the DHT with information for targeting improvements in quality of care. The study objectives were to, i) assess patient satisfaction with quality of care provided in health units in Mukono District, ii) assess the quality of the process of health care delivery. In health units in Mukono District, iii) assess health care provider prescribing behavior using treatment of malaria in children under five years as a proxy indicator, and iv) determine factors that influence delivery of quality health care among health care providers in Mukono District. A descriptive cross sectional study was done. A stratified sample of eighteen health units was selected. Three hundred and eighty seven patients were interviewed to assess satisfaction with the quality of health care. To assess the process of health care delivery, 18 health care providers were observed attending to three sick under five year old children each. Health care provider prescribing behavior was assessed retrospectively by a review of records of malaria treatment in children under five years old. Three hundred and eighty four records of previous six months were reviewed. Factors affecting delivery of quality care by health care providers was assessed by use of key informant interviews. The results on patient satisfaction revealed that 15.5% (601387) of patient respondents were completely satisfied with the overall quality of care provided in the health units. Eighty percent (31 11387) were satisfied, 4% (141387) were dissatisfied and 0.5% (21387) were completely dissatisfied. The quality of the process of care was assessed using a scoring system. At a cut off mark of 60% of the expected total score, only 35.2% of the children were managed adequately. This study also found that on average, 3.2 drugs were dispensed to each child with malaria and 41.8% received antibiotics. Eighty five percent received an injection and only 48.3% were treated according to NSTG. The key informants thought that factors that contribute to quality health care were availability of drugs and equipment, adequate staffing with trained personnel, regular effective support supervision, and motivation of health care providers. From the findings of this study, it may be concluded that patients are generally satisfied with the quality of health care provided in the health units of Mukono District. However technical competence of health care providers does not reach required standards. It is therefore recommended that the DHT of Mukono District focus training of health care providers on clinical case management of common childhood illnesses and rational drug us
Trends and geospatial distribution of stillbirths in Uganda, 2014–2020
No full textAbstract Introduction Uganda with 17.8 stillbirths per 1,000 deliveries in 2021, is among the countries with a high burden of stillbirths globally. In 2014, Uganda adopted the World Health Organization Every New-born Action Plan (ENAP), which targets 28 weeks of pregnancy or weighing > 1000 g before or during birth and reported to a health facility. We calculated annual incidence rates of stillbirths per 1,000 deliveries at district, regional, and national levels. We used logistic regression to determine the significance of trends. Results The overall national annual incidence of stillbirths decreased from 24/1,000 deliveries in 2014 to 17/1,000 deliveries in 2020. During the same period, reporting rates declined from 71% in 2014 to 46% in 2020. The central region continuously had the highest incidence rate for the past 5 years despite the largest decline (OR = 0.79; CI = 0.77–0.83, P 30/1000) included Mubende, Kalangala, Hoima, and Nebbi. There was no difference in the reporting rates of the most- vs. least-affected districts. Conclusion Even with suboptimal reporting, the incidence of stillbirths remained above the national target. Specific areas in the country appear to have particularly high stillbirth rates. We recommend continuous capacity building in managing pregnant women with an emphasis on the most affected districts, and investigation into the reasons for low reporting
Emerg Infect Dis
No full textThe COVID-19 pandemic spread between neighboring countries through land, water, and air travel. Since May 2020, ministries of health for the Democratic Republic of the Congo, Tanzania, and Uganda have sought to clarify population movement patterns to improve their disease surveillance and pandemic response efforts. Ministry of Health-led teams completed focus group discussions with participatory mapping using country-adapted Population Connectivity Across Borders toolkits. They analyzed the qualitative and spatial data to prioritize locations for enhanced COVID-19 surveillance, community outreach, and cross-border collaboration. Each country employed varying toolkit strategies, but all countries applied the results to adapt their national and binational communicable disease response strategies during the pandemic, although the Democratic Republic of the Congo used only the raw data rather than generating datasets and digitized products. This 3-country comparison highlights how governments create preparedness and response strategies adapted to their unique sociocultural and cross-border dynamics to strengthen global health security
Health Secur
No full textUganda's proximity to the tenth Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo (DRC) presents a high risk of cross-border EVD transmission. Uganda conducted preparedness and risk-mapping activities to strengthen capacity to prevent EVD importation and spread from cross-border transmission. We adapted the World Health Organization (WHO) EVD Consolidated Preparedness Checklist to assess preparedness in 11 International Health Regulations domains at the district level, health facilities, and points of entry; the US Centers for Disease Control and Prevention (CDC) Border Health Capacity Discussion Guide to describe public health capacity; and the CDC Population Connectivity Across Borders tool kit to characterize movement and connectivity patterns. We identified 40 ground crossings (13 official, 27 unofficial), 80 health facilities, and more than 500 locations in 12 high-risk districts along the DRC border with increased connectivity to the EVD epicenter. The team also identified routes and congregation hubs, including origins and destinations for cross-border travelers to specified locations. Ten of the 12 districts scored less than 50% on the preparedness assessment. Using these results, Uganda developed a national EVD preparedness and response plan, including tailored interventions to enhance EVD surveillance, laboratory capacity, healthcare professional capacity, provision of supplies to priority locations, building treatment units in strategic locations, and enhancing EVD risk communication. We identified priority interventions to address risk of EVD importation and spread into Uganda. Lessons learned from this process will inform strategies to strengthen public health emergency systems in their response to public health events in similar settings.001/WHO_/World Health OrganizationInternational/CC999999/ImCDC/Intramural CDC HHSUnited States
Health Secur
No full textUganda is highly vulnerable to public health emergencies (PHEs) due to its geographic location next to the Congo Basin epidemic hot spot, placement within multiple epidemic belts, high population growth rates, and refugee influx. In view of this, Uganda's Ministry of Health established the Public Health Emergency Operations Center (PHEOC) in September 2013, as a central coordination unit for all PHEs in the country. Uganda followed the World Health Organization's framework to establish the PHEOC, including establishing a steering committee, acquiring legal authority, developing emergency response plans, and developing a concept of operations. The same framework governs the PHEOC's daily activities. Between January 2014 and December 2021, Uganda's PHEOC coordinated response to 271 PHEs, hosted 207 emergency coordination meetings, trained all core staff in public health emergency management principles, participated in 21 simulation exercises, coordinated Uganda's Global Health Security Agenda activities, established 6 subnational PHEOCs, and strengthened the capacity of 7 countries in public health emergency management. In this article, we discuss the following lessons learned: PHEOCs are key in PHE coordination and thus mitigate the associated adverse impacts; although the functions of a PHEOC may be legalized by the existence of a National Institute of Public Health, their establishment may precede formally securing the legal framework; staff may learn public health emergency management principles on the job; involvement of leaders and health partners is crucial to the success of a public health emergency management program; subnational PHEOCs are resourceful in mounting regional responses to PHEs; and service on the PHE Strategic Committee may be voluntary.CC999999/ImCDC/Intramural CDC HHSUnited States
Additional file 1 of Trends and geospatial distribution of stillbirths in Uganda, 2014–2020
No full textSupplementary Material
The COVID-19 pandemic in the African continent
No full textIn December 2019, a new coronavirus, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and associated disease, coronavirus disease 2019 (COVID-19), was identified in China. This virus spread quickly and in March, 2020, it was declared a pandemic. Scientists predicted the worst scenario to occur in Africa since it was the least developed of the continents in terms of human development index, lagged behind others in achievement of the United Nations sustainable development goals (SDGs), has inadequate resources for provision of social services, and has many fragile states. In addition, there were relatively few research reporting findings on COVID-19 in Africa. On the contrary, the more developed countries reported higher disease incidences and mortality rates. However, for Africa, the earlier predictions and modelling into COVID-19 incidence and mortality did not fit into the reality. Therefore, the main objective of this forum is to bring together infectious diseases and public health experts to give an overview of COVID-19 in Africa and share their thoughts and opinions on why Africa behaved the way it did. Furthermore, the experts highlight what needs to be done to support Africa to consolidate the status quo and overcome the negative effects of COVID-19 so as to accelerate attainment of the SDGs
First laboratory confirmation and sequencing of Zaire ebolavirus in Uganda following two independent introductions of cases from the 10th Ebola Outbreak in the Democratic Republic of the Congo, June 2019.
No full textUganda established a domestic Viral Hemorrhagic Fever (VHF) testing capacity in 2010 in response to the increasing occurrence of filovirus outbreaks. In July 2018, the neighboring Democratic Republic of Congo (DRC) experienced its 10th Ebola Virus Disease (EVD) outbreak and for the duration of the outbreak, the Ugandan Ministry of Health (MOH) initiated a national EVD preparedness stance. Almost one year later, on 10th June 2019, three family members who had contracted EVD in the DRC crossed into Uganda to seek medical treatment. Samples were collected from all the suspected cases using internationally established biosafety protocols and submitted for VHF diagnostic testing at Uganda Virus Research Institute. All samples were initially tested by RT-PCR for ebolaviruses, marburgviruses, Rift Valley fever (RVF) virus and Crimean-Congo hemorrhagic fever (CCHF) virus. Four people were identified as being positive for Zaire ebolavirus, marking the first report of Zaire ebolavirus in Uganda. In-country Next Generation Sequencing (NGS) and phylogenetic analysis was performed for the first time in Uganda, confirming the outbreak as imported from DRC at two different time point from different clades. This rapid response by the MoH, UVRI and partners led to the control of the outbreak and prevention of secondary virus transmission
VHF pathogens detected during first year of EVD preparedness period in Uganda 1<sup>st</sup> August 2018 – 30<sup>th</sup> December 2019.
No full textVHF pathogens detected during first year of EVD preparedness period in Uganda 1st August 2018 – 30th December 2019.</p
