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1
Asiimwe, P., P. Ebusu, and D. Olodi. "World Cancer Day As a Platform for Advocacy, Stakeholder Mobilization and Awareness Creation: The Experience of Uganda Cancer Society." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 169s. http://dx.doi.org/10.1200/jgo.18.69800.
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Background: World Cancer Day (WCD) provides a platform to raise awareness. This year Uganda's commemoration was held at the Parliamentary grounds. Aim: To bring together Uganda's stakeholders through an inclusion approach to advocate for, share information and raise awareness on cancer while recognizing efforts made and appreciating challenges faced in the fight against the epidemic. Strategy: Partnership building was key. Partners involved were; Uganda Cancer Society (UCS), Uganda Cancer Institute (UCI), Ministry of Health, World Health Organization, media, Uganda Corporate League, interreligious council, Kampala Capital City Authority, Parliament of Uganda, Uganda Police and UCS member organizations. Program process: A committee was set up and a concept developed adopting the tri-process approach; “Before - During - After” for implementation of activities. Outcomes: The digital campaign was launched using the signs for change and the #WeCanICanUg. There was high media coverage; 3 major national stations Urban TV, NBS TV and NTV UG, one regional station-CGTN Africa, as well as online platforms such as; WHO Africa Web site, UICC World Cancer Day impact report, the Grape Vine, Chimp reports, and more than 5 YouTube media uploads as per our monitoring and surveillance efforts on reach and impact. The lighting of the Queen's way clock tower attracted many passersby and media coverage. In addition there was awareness creation in select churches (6) and mosques (2) on 4th and 2nd February respectively. The WCD ceremony was attended by over 400 guests and officiated by the Speaker of Parliament who doubled as chief walker. The 7.3 km match past attracted involvement of the community along the way. The Speaker called upon the government through Ministry of Health to inject more money into training of more cancer specialists to work on cancer patients. She also stated the need to have cancer services moved closer than just the regional centers but to every district referral hospital for cancer screening and cancer treatment. She pledged Parliament's unconditional support to work with civil society in the cancer fight. The Minister of Health committed to the full operationalization of regional cancer centers by 2019. She applauded the role of civil society through Uganda Cancer Society on the advocacy efforts stating that they had already started yielding good results . The event ended with the corporate league football competitions which were aimed at promoting healthy lifestyles through physical exercise. Notably was the match between the Parliamentary team and the UCI team. The winner was given a trophy marked WCD 2018. What was learned: The role of civil society through umbrella bodies like UCS plays a crucial role in cancer control as seen during through planning, mobilization, partnership building and execution of WCD activities. Creativity and innovation is key in generating stakeholder and public interest in cancer control activities like WCD.
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Agwang, A., H. Ngonzi, and J. Ekudo. "Working With Organized Groups to Change Cultural Beliefs and Norms Toward Cancer in Uganda." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 142s. http://dx.doi.org/10.1200/jgo.18.56900.
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Background and context: Cultural norms, beliefs and practices are great hindrance to efforts toward early detection and treatment of cancer in Uganda as most of the individuals believe its witchcraft, curse or bad luck. Working with organized groups such as churches, cultural associations, women associations, is key in changing such beliefs. HealthAid Uganda (HAU) for the last 3 years has worked in partnership with Watoto Church among other groups to deliver cancer awareness, screening and screening for other health problems in the districts of Mukono, Kampala and Wakiso. Aim: To mobilize organized groups within the community to raise awareness about cancer to correct prevailing myths, misconceptions and negative cultural beliefs, norms and practices. Strategy/Tactics: HAU built a strong partnership with its target groups one of which being Watoto church with whom joint planning activities were carried out. It involved the review of HAU's previous community health outreaches as a source of experience. The review also gave insight into the development of the activity plan; including the services to be rendered, the community leaders to be involved and the day in which the events would be conducted. The event included health talks on HPV, cervical and breast cancer, testimonies by the survivors, practical demonstration for self-breast examination, cervical cancer screening and distribution of cancer education materials. Program/Policy process: Involvement of community groups and champions in changing beliefs toward cancer epidemic is key. Outcomes: There was increased spirit of partnership which attracted various civil society organizations with Watoto church being the key partner. The government health center administration recognized efforts and pledged to offer further support in mobilizing the community. The awareness walk attracted public participation and need for the services. It demonstrated need to further work with organized groups within the community to form cancer task force groups to bring cancer information to every household. The events were covered by media, leading to increased demand for the services provided, with estimated 1500 individuals who received with both awareness, screening and consultative services. What was learned: HAU-Watoto partnership involvement showed that working with organized groups produces better results in cancer control and treatment in Uganda. Indeed changing cultural beliefs, norms and practices toward cancer prevention and control can be a success story if working with organized local groups is taken into consideration as a tool to reaching out to individuals and the approach during this year showed much more results than 2016.
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Burt, Jessica Florence, Joseph Ouma, Lawrence Lubyayi, Alexander Amone, Lorna Aol, Musa Sekikubo, Annettee Nakimuli, et al. "Indirect effects of COVID-19 on maternal, neonatal, child, sexual and reproductive health services in Kampala, Uganda." BMJ Global Health 6, no. 8 (August 2021): e006102. http://dx.doi.org/10.1136/bmjgh-2021-006102.
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BackgroundCOVID-19 impacted global maternal, neonatal and child health outcomes. We hypothesised that the early, strict lockdown that restricted individuals’ movements in Uganda limited access to services.MethodsAn observational study, using routinely collected data from Electronic Medical Records, was carried out, in Kawempe district, Kampala. An interrupted time series analysis assessed the impact on maternal, neonatal, child, sexual and reproductive health services from July 2019 to December 2020. Descriptive statistics summarised the main outcomes before (July 2019–March 2020), during (April 2020–June 2020) and after the national lockdown (July 2020–December 2020).ResultsBetween 1 July 2019 and 31 December 2020, there were 14 401 antenatal clinic, 33 499 deliveries, 111 658 childhood service and 57 174 sexual health attendances. All antenatal and vaccination services ceased in lockdown for 4 weeks.During the 3-month lockdown, the number of antenatal attendances significantly decreased and remain below pre-COVID levels (370 fewer/month). Attendances for prevention of mother-to-child transmission of HIV dropped then stabilised. Increases during lockdown and immediately postlockdown included the number of women treated for high blood pressure, eclampsia and pre-eclampsia (218 more/month), adverse pregnancy outcomes (stillbirths, low-birth-weight and premature infant births), the rate of neonatal unit admissions, neonatal deaths and abortions. Maternal mortality remained stable. Immunisation clinic attendance declined while neonatal death rate rose (from 39 to 49/1000 livebirths). The number of children treated for pneumonia, diarrhoea and malaria decreased during lockdown.ConclusionThe Ugandan response to COVID-19 negatively impacted maternal, child and neonatal health, with an increase seen in pregnancy complications and fetal and infant outcomes, likely due to delayed care-seeking behaviour. Decreased vaccination clinic attendance leaves a cohort of infants unprotected, affecting all vaccine-preventable diseases. Future pandemic responses must consider impacts of movement restrictions and access to preventative services to protect maternal and child health.
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Ajulong, Martha Grace, John Charles Okiria, and Martin Owako. "Factors Influencing Annual Procurement Planning of Medicines and Medical Supplies in Public Health Facilities in Kampala District." Rwanda Journal of Medicine and Health Sciences 4, no. 2 (September 10, 2021): 292–309. http://dx.doi.org/10.4314/rjmhs.v4i2.8.
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BackgroundDespite significant progress made by many countries towards meeting the millennium development goals and now sustainable development goals, there has been little improvement in access to essential medicines in developing countries.ObjectivesThe main aim of this study is to assess the factors influencing annual procurement planning of medicines and medical supplies in the public health facilities in Kampala district.MethodsThis study targeted respondents from government Health facilities in Kampala with a total population of 424 employees and applied simple random sampling to select 206 health workers. The researcher adopted mixed research approach with application of descriptive statistics, correlational and explanatory research designs that were used to maximize reliability and validity of findings. While the qualitative data was gathered through reviewing logistics tools, a physical count of the 30% purposively selected stock cards and interview of the staffs was carried out in health facilities in Kampala district, a Statistical Package for Social Science (SPSS) version 20 was used to analyze the quantitative data. Accordingly, a chi-square was used to determine the association between independent and dependent variables.ResultsThe findings indicated that 37.8% of the staff responded positively about the availability of annual procurement plan while the rest were from various health facilities. A significant association was observed between knowledge and availability of annual Procurement planning (X2 = 34.7; p value =.0001), as well as management support and Annual Procurement Planning (X2 = 9.87; P value = .008).ConclusionIn conclusion, the finding generated from analysis of quantitative and qualitative data revealed that a majority of the factors influencing annual procurement planning had a positive effect on medical supplies in public health facilities in Uganda although the capacity and capability of health workers, quality of logistics management information systems, and management support desires improvement.
Rwanda J Med Health Sci 2021;4(2): 292-309
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Ssempebwa, John C., Rawlance Ndejjo, Ruth Mubeezi Neebye, Edwinah Atusingwize, and Geofrey Musinguzi. "Determinants of Exposures to Hazardous Materials among Nail Cosmeticians in the Kampala City, Uganda." Journal of Environmental and Public Health 2019 (April 1, 2019): 1–9. http://dx.doi.org/10.1155/2019/1925863.
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Globally, nail salons represent a fast expanding industry and often with low-income cosmeticians. In general, cosmeticians have limited access to safety information about the hazardous materials they handle, which would potentially enable them to minimize workplace exposures. The problem is much pronounced in low- and middle-income countries due to weaknesses in regulation of the industry. We investigated determinants of exposures to hazardous materials among nail cosmeticians in Kampala District, Uganda. We employed a cross-sectional study design among a random sample of 243 participants. The sociodemographic characteristics, education and training status, knowledge about routes of exposure to hazardous chemicals, and personal protective material use of cosmeticians were assessed through face-to-face interviews. Most cosmeticians were aged 18–34 years, and more males were engaged in this work than females. Also, 82.7% believed inhalation was the major exposure route for the chemicals they handled. Participants who had attained secondary-level education and above were over three times more likely to wear masks (AOR = 3.19, 95% CI 1.58–6.41) and gloves (AOR = 3.48, 95% CI 1.55–7.81) and over two times more likely to use aprons (AOR = 2.50, 95% CI 1.18–5.32). Participants who had ever received safety training on hazardous chemicals were more likely to wear all four personal protective equipment: masks (AOR = 3.21, 95% CI 1.61–6.42), gloves (AOR = 4.23, 95% CI 2.05–8.75), goggles (AOR = 4.14, 95% CI 1.25–13.65), and aprons (AOR = 2.73, 95% CI 1.25–5.96). Participants who had spent more than two years in the nail cosmetics business were more likely to wear masks (AOR = 3.37, 95% CI 1.64–6.95). With the increasing demand for nail cosmetics, and many people in urban areas of low-income countries engaging in this industry, there is need for training and better workplace policies to promote a healthier urban workforce dealing in cosmetics.
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Akatukwasa, Cecilia, Francis Bajunirwe, Simpson Nuwamanya, Noel Kansime, Emmanuel Aheebwe, and Imelda K. Tamwesigire. "Integration of HIV-Sexual Reproductive Health Services for Young People and the Barriers at Public Health Facilities in Mbarara Municipality, Southwestern Uganda: A Qualitative Assessment." International Journal of Reproductive Medicine 2019 (April 10, 2019): 1–11. http://dx.doi.org/10.1155/2019/6725432.
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Background. Sexual and Reproductive Health (SRH) and HIV risk behaviors for young people are intertwined. This rationalizes the need for integration of HIV and SRH services within the health care system, especially in countries with high HIV burden. In this study, we explored the current status of HIV-SRH integration for young people and barriers of integration from different stakeholders at public health facilities in Mbarara Municipality, southwestern Uganda. Methods. We conducted an exploratory qualitative study at public health facilities in Mbarara district of southwestern Uganda. Data were collected among young people (n=48), health care providers (n=63), and key informants (n=11). We used in-depth interviews and focus group discussions to collect the data. Coding and analysis of qualitative data were done using Atlas.ti. Results. Overall there was no differentiation of HIV-SRH services between adults and young people. Integration of HIV-SRH services was reported at all facility levels; however, there was poor differentiation of services for the young persons and adults. Integrated HIV and SRH services for young people were acknowledged to improve access to information and risk perception, improve continuity of care, and reduce cost of services and would also lead to improved client-health worker relationships. The potential barriers to achieving HIV-SRH integration included individual provider characteristics like lack of training and attitudes, generic health system challenges like low staffing levels, poor infrastructure with lack of space and privacy to deliver these services. At the policy level vertical programing and unclear policies and guidelines were identified as challenges. Conclusion. Our study shows integration of HIV and SRH services exists in general but services for adults and young people are blended or poorly differentiated. Significant health system barriers need to be overcome to achieve differentiation of the services for young people and adults.
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Mwesigwa, Catherine Lutalo, Brenda Akinyi Okumu, Charity Kirabo-Nagemi, Emma Ejuu, Estie Kruger, and Marc Tennant. "Mapping the geographic availability of public dental services in Uganda relative to ruralization and poverty of the population." Journal of Global Oral Health 2 (February 29, 2020): 86–92. http://dx.doi.org/10.25259/jgoh_66_2019.
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Objectives: Uganda is a low-income country faced with a number of challenges in health service delivery, including oral health services. Despite reports of an increased prevalence of oral diseases, they are afforded less priority, amidst competing priorities of infectious and other non-communicable diseases. Oral health-care services are offered free-of-charge in public health facilities. The majority of the Ugandan population live in rural areas. This would imply that public dental services should be more widely distributed in rural areas to meet the needs of the majority population. This study, therefore, aimed to determine the geographic distribution of public dental services relative to poverty and ruralization of the Ugandan population. Materials and Methods: All 112 districts in Uganda were to be surveyed for this study using an ecological design that incorporated the Ugandan population with socio-demographics obtained from the latest Uganda National Housing and Population Census and poverty data from the national Poverty Status Report 2014. The data from the districts were on the availability of public dental services and the physical location of these dental facilities. Overall, 182 public facilities were included in the study. The geographic location of public dental clinics was established using open-data sources. The data on ruralization were aggregated at the district level and that on poverty at the subregion level. Spatial analysis was done using geographic information science software, Quantum Geographic Information System. Results: The total Ugandan population was 34 million. Overall, 19.7% of the population was poor with the highest proportion located in the North and East of Uganda. Urban-rural characteristics varied across the country. Information on the 182 public dental clinics was collected from 97 of the 112 Ugandan districts. Among the 97 districts, 15% had no public clinic and were located in the poorest Ugandan regions. Among the 40 districts containing over 90% of the rural population, 20% had none, and 55% only had one dental clinic. In general, service availability reduced as the proportion of the rural and poor population increased. Conclusion: The spatial analysis presents an avenue to inform and guide the decision making and planning process by identifying geographic areas with access gaps relative to population socio-demographic characteristics. This study revealed that public dental services were least available for the poorest and rural populations, and yet they are already vulnerable to other access barriers. It is recommended that efforts should be made by health planners and policymakers to avert the health inequalities presented by inequitable access.
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Franco, Gabala, Juliet Ndibaisa, and Namumbya Slivia. "Women Mobile Lifeline Channel Is a Key Stimulant of MCH Services Use in Resource Constrained Settings: A Success Story of Women Health Channel Uganda." Iproceedings 5, no. 1 (October 2, 2019): e15239. http://dx.doi.org/10.2196/15239.
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Background Uganda has made progress in recent decades; however, the country still ranks among the top 10 countries in the world with high maternal, newborn, and child mortality rates. 336 women in every 100000 live births die due to preventable pregnancy related causes (under-five mortality rate 64/1000 live births; infant mortality rate 43/1000 live births; and neonatal mortality rate 27/1000 live births). Despite the growing global focus on reaching the last mile that necessitates the development of mHealth tools that best reach, empower, and mobilize the last mile women to seek and utilize critical and life-saving health care services as a vehicle for accelerating reduction of maternal and child deaths, mHealth tools in Uganda continue to limit focus on reporting and trucking of health indicators. Objective MIRA Channel is a single-window app with multiple channels on prenatal care, child immunization, newborn care, and family planning with the objective to improve maternal and child health outcomes in rural and resource-constrained settings. The app delivers information to women through interactive edutainment tools that builds on their knowledge, thus creating awareness on critical health issues and preempt timely use of MCH services. Methods Women Health Channel Uganda piloted the Women Mobile Lifeline Channel app in 15 public health facilities in Jinja district, Uganda, and particularly targeted pregnant women. A systematic review of records, particularly the health facility ANC register, was done to estimate the facility clientele size. Purposive random sampling was used to arrive at the survey sample. Two contact midwives and 5 VHTs were selected, trained, and given a connected mobile device at each of the implementing health facilities. Recruitment of women on the platform was done by VHTs using connected phones at community level, and 3489 pregnant women were studied for 16 months. Data was collected at baseline and at end line. Results Both at baseline and at end line, information on knowledge as well as usage of key MCH services was collected. All women had heard of ANC and the recommended place of delivery; however, only 59% at baseline had knowledge of the exact recommended number of ANC visits as opposed to 94% at end line. At baseline, 36% of women reported to have attended ANC 4 or more times at the most recent pregnancy as opposed to 82% at end line, while 63% of women at baseline reported to have given birth in a health facility for the previous pregnancy as opposed to 94% at end line. Sven neonatal deaths were reported in the cohort at baseline as opposed to 0 maternal deaths and 1 neonatal death at end line. Conclusions The pilot showed that one critical determinant of use of MCH services is the overall client knowledge and the perceived available support mechanism in the face of challenges. mHealth tools ought to expand focus to include stimulation of two-way mobile-based interactions that reinforce behavior change and preempt use as such. The Women Mobile Lifeline Channel that Women Health Channel is implementing offers lenses for Uganda and other countries to walk towards meaningful ICT integration in health.
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Akullo, Pamella Stella, Patrick Rolex Akena, and David Mwesigwa. "Awareness creation as a strategy to reducing the rate of teenage pregnancy in Lira District." Advances in Social Sciences Research Journal 7, no. 9 (October 4, 2020): 579–88. http://dx.doi.org/10.14738/assrj.79.9005.
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Teenage pregnancy is a serious public health and social problem, with 95%% occurring in developing countries. This study aimed to seek explain how awareness creation can be used to reduce the rate of teenage pregnancies in Lira district. A descriptive survey design was used and the study population was teenage girls. Data was collected using a document review guide since only secondary data was used in this study because of the short time. Secondary data got from plan Uganda Results indicates a drop in teenage pregnancy in five sub-counties in Lira District. It was further found established that the use of mass media and community dialogue helps in reducing the risk of teenage pregnancy by influencing behaviour towards contraceptive use, acquainting teenagers with knowledge of pregnancy prevention, creating a positive social environment. Radio programs and newspapers releases like straight talk and rock point 256 are among the mass media programs used to create awareness about teenage pregnancy. Alternatives of to reducing teenage pregnancy were are birth control, use of modern contraceptives, awareness about birth control, keeping teenagers in school, and positive religious beliefs have also been found as a major factor. Interventions focusing on retaining pregnant and married girls at in school, information on sexual and reproductive health of teenage girls, improving access to and information about contraceptive use among teenage girls, improving socio-economic status of households, and law enforcement on sexual abuse among girls may should be used to improving improve adolescent sexual and health services in Lira District.
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Zziwa, Swaibu, Harriet Babikako, Doris Kwesiga, Olive Kobusingye, Jacob A. Bentley, Frederick Oporia, Rebecca Nuwematsiko, Abdulgafoor Bachani, Lynn M. Atuyambe, and Nino Paichadze. "Prevalence and factors associated with utilization of rehabilitation services among people with physical disabilities in Kampala, Uganda. A descriptive cross sectional study." BMC Public Health 19, no. 1 (December 2019). http://dx.doi.org/10.1186/s12889-019-8076-3.
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Abstract Background Worldwide, fifteen percent (15%) of the world’s population or one (1) billion people live with some form of disability. In Uganda, 12.4% of the Uganda’s population lives with some form of disability and Kawempe division accounts for (22.6%) of all persons with disabilities living in Kampala district. Rehabilitation services are provided within Kawempe division at Mulago hospital physiotherapy department and Katalemwa rehabilitation center in Kampala district, Uganda at a free and a subsidized cost to help to improve the function, independence, and quality of life of persons with physical disabilities. However, many people with physical disabilities do not utilize the services and the reasons are not clear. Methods The study design was a descriptive cross-sectional study employing quantitative methods of data collection. A total of 318 participants were included in the study. Simple random sampling was used to select the study participants. Ethical issues were maintained at all levels during data collection and dissemination of results. Results The study revealed a prevalence of 26.4% of the utilization rehabilitation services among people with physical disabilities in Kawempe division, Kampala, Uganda. Factors that were significantly associated with utilization of rehabilitation services among people with physical disabilities at multivariable logistic regression analysis included; age (AOR: 0.30; 95% CI: 0.12–0.74), socioeconomic status (AOR: 2.13; 95% CI: 1.03–4.41), education level (AOR: 4.3; 95% CI: 1.34–13.91) and awareness of the participants about the rehabilitation services (AOR: 5.1; 95% CI: 2.74–9.54) at p value ≤0.05. Conclusion The study revealed a prevalence of 26.4% of the utilization rehabilitation services among people with physical disabilities in Kawempe division, Uganda. Factors that were significantly associated with utilization of rehabilitation services included; age, socioeconomic status, education level and awareness of the participants about the services. Therefore, the government and other relevant stake holders should increase sensitization and awareness of rehabilitation services, their benefits and facilities providing such services to people with physical disabilities, healthcare professionals and the general public.
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Obol, James Henry, Reema Harrison, Sophia Lin, Mark James Obwolo, and Robyn Richmond. "Perceptions of key informants on the provision of cervical cancer prevention and control programme in Uganda: implication for cervical cancer policy." BMC Public Health 20, no. 1 (September 14, 2020). http://dx.doi.org/10.1186/s12889-020-09482-y.
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Abstract Background Uganda has one of the highest burdens of cervical cancer globally. In 2010 the Ugandan Ministry of Health launched the Strategic Plan for Cervical Cancer Prevention and Control with the hope of developing cervical cancer policy in Uganda. This study explored the beliefs of senior key informants in Uganda about cervical cancer prevention, the control programme, and the relevance of cervical cancer policy. Methods We conducted 15 key informant interviews with participants from six organisations across Northern and Central Uganda. Participants were drawn from district local government health departments, St. Mary’s Hospital Lacor, Uganda Nurses and Midwifery Council, non-governmental organisations (NGOs) and Ministry of Health in Kampala, Uganda. The interview recordings were transcribed and analysed using thematic analysis. Results Seven themes emerged relating to the cervical cancer prevention and control programmes in Uganda: (1) policy frameworks for cervical cancer, (2) operationalising cervical cancer prevention and control, (3) financial allocation and alignment, (4) human resources and capability, (5) essential supplies and vaccines, (6) administrative data and resource distribution, and (7) cervical cancer services. Conclusions The key informants perceive that the lack of a cervical cancer policy in Uganda is hindering cervical cancer prevention and control programmes. Therefore, the Ministry of Health and stakeholders need to work together in coming up with an effective policy framework that will accelerate efforts towards cervical cancer prevention and control in Uganda.
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Kagoya, Harriet R., and Dan Kibuule. "Quality assurance of health management information system in Kayunga district, Uganda." African Evaluation Journal 6, no. 2 (September 12, 2018). http://dx.doi.org/10.4102/aej.v6i2.238.
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Background: An efficient health management information system (HMIS) improves health care delivery and outcomes. However, in most rural settings in Uganda, paper-based HMIS are widely used to monitor public health care services. Moreover, there are limited capabilities and capacity for quality HMIS in remote settings such as Kayunga district.Objectives: The quality assurance practices of HMIS in health centres (HCs) in Kayunga district were evaluated.Method: A cross-sectional descriptive study design was used to assess the quality of HMIS at 21 HCs in Kayunga district. Data were collected through in-depth interviews of HMIS focal persons as well as document analysis of HMIS records and guidelines between 15 June 2010 and 15 July 2010. The main outcomes were quality assurance practices, the HMIS programmatic challenges and opportunities. The practice of HMIS was assessed against a scale for good quality assurance practices. Qualitative data were coded and thematically analysed, whereas quantitative data were analysed by descriptive statistics using SPSS v22 software.Results: All the 21 HCs had manual paper-based HMIS. Less than 25% of HCs practised quality assurance measures during collection, compilation, analysis and dissemination of HMIS data. More than 50% of HCs were not practising any type of quality assurance during analysis and dissemination of data. The main challenges of the HMIS were the laborious and tedious manual system, the difficulty to archive and retrieve records, insufficient HMIS forms and difficulty in delivering hard copies of reports to relevant stakeholders influenced quality of data. Human resource challenges included understaffing where 43% of participating HCs did not have a designated HMIS staff.Conclusion: The HMIS quality assurance practices in Kayunga were suboptimal. Training and support supervision of HMIS focal persons is required to strengthen quality assurance of HMIS. Implementation of electronic HMIS dashboards with data quality checks should be integrated alongside the manual system.
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Kyozira, Caroline, Catherine Kabahuma, and Jamiru Mpiima. "Integration of the UNHCR Refugee Health Information System into the National Health Information Management System for Uganda." Health Information Management Journal, December 6, 2019, 183335831988781. http://dx.doi.org/10.1177/1833358319887817.
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Background: The Uganda Government, together with development partners, has provided continuing support services (including protection, food, nutrition, healthcare, water and sanitation) to refugee-hosting Districts to successfully manage refugees from different neighbouring countries in established settlements. This service has increased the need for timely and accurate information to facilitate planning, resource allocation and decision-making. Complexity in providing effective public health interventions in refugee settings coupled with increased funding requirements has created demands for better data and improved accountability. Health data management in refugee settings is faced with several information gaps that require harmonisation of the Ugandan National Health Management Information System (UHMIS) and United Nations High Commission for Refugees (UNHCR) Refugee Health Information System (RHIS). This article discusses the rationale for harmonisation of the UNHCR RHIS, which currently captures refugee data, with the UHMIS. It also provides insights into how refugee health data management can be harmonised within a country’s national health management information system. Method: A consultative meeting with various stakeholders, including the Ugandan Ministry of Health, district health teams, representatives from UNHCR, the United Nations Children Education Fund (UNICEF), United States Government and civil society organisations, was held with an aim to review the UHMIS and UNHCR RHIS health data management systems and identify ways to harmonise the two to achieve an integrated system for monitoring health service delivery in Uganda. Results: Several challenges facing refugee-hosting district health teams with regard to health data management were identified, including data collection, analysis and reporting. There was unanimous agreement to prioritise an integrated data management system and harmonisation of national refugee stakeholder data requirements, guided by key recommendations developed at the meeting. Conclusion: This article outlines a proposed model that can be used to harmonise the UNHCR RHIS with the UHMIS. The national refugee stakeholder data requirements have been harmonised, and Uganda looks forward to achieving better health data quality through a more comprehensive national UHMIS to inform policy planning and evidence-based decision-making.
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Ssensamba, Jude Thaddeus, Moses Mukuru, Mary Nakafeero, Ronald Ssenyonga, and Suzanne N. Kiwanuka. "Health systems readiness to provide geriatric friendly care services in Uganda: a cross-sectional study." BMC Geriatrics 19, no. 1 (September 18, 2019). http://dx.doi.org/10.1186/s12877-019-1272-2.
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Abstract Background As ageing emerges as the next public health threat in Africa, there is a paucity of information on how prepared its health systems are to provide geriatric friendly care services. In this study, we explored the readiness of Uganda’s public health system to offer geriatric friendly care services in Southern Central Uganda. Methods Four districts with the highest proportion of old persons in Southern Central Uganda were purposively selected, and a cross-section of 18 randomly selected health facilities (HFs) were visited and assessed for availability of critical items deemed important for provision of geriatric friendly services; as derived from World Health Organization’s Age-friendly primary health care centres toolkit. Data was collected using an adapted health facility geriatric assessment tool, entered into Epi-data software and analysed using STATA version 14. Kruskal-Wallis and Dunn’s post hoc tests were conducted to determine any associations between readiness, health facility level, and district. Results The overall readiness index was 16.92 (SD ±4.19) (range 10.8–26.6). This differed across districts; Lwengo 17.91 (SD ±3.15), Rakai 17.63 (SD ±4.55), Bukomansimbi 16.51 (SD ±7.18), Kalungu 13.74 (SD ±2.56) and facility levels; Hospitals 26.62, Health centers four (HCIV) 20.05 and Health centers three (HCIII) 14.80. Low readiness was due to poor scores concerning; leadership (0%), financing (0%), human resources (1.7%) and health management information systems (HMIS) (11.8%) WHO building blocks. Higher-level HFs were statistically significantly friendlier than lower-level HFs (p = 0.015). The difference in readiness between HCIIIs and HCIVs was 2.39 (p = 0.025). Conclusion There is a low readiness for public health facilities to provide geriatric friendly care services in Uganda. This is due to gaps in all of the health system building blocks. There is a need for health system reforms in Uganda to adequately cater for service provision for older adults if the 2020 global healthy ageing goal is to be met.
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Piccinni, G., and G. Putoto. "Clear proceedings as workplace health promotion. Supervision and management tools in rural Uganda." European Journal of Public Health 29, Supplement_4 (November 1, 2019). http://dx.doi.org/10.1093/eurpub/ckz186.439.
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Abstract Health centres and supervision teams in rural/poor settings in developing countries are affected by limited resources, uneasy reporting to higher level of power and unclear proceedings to filling the gaps. Inconsistency in supervising visits lead to mistrust. Supervisees react with resistance or indifference. Supervisors react behaving as policemen. In Uganda, Oyam Health District, february-august 2018, actions were taken in order to solve conflicts, sustain quality, improve interactions. Sharing the concept and the implementing process could inspire colleagues engaged in workplace health promotion. Key points were informed by direct observations, talks with staffs, literature review, ugandan Ministry of Health official directives and tools, NGO’s adaptations. Selected issues were discussed during two workshops held in april ’18 involving all the concerned staff: 100 people. Agreement reached, based on a 3 (gap-act-resp) 5 (0-4 grading) algorithm, re-designed tools were able to reduce aléa during inspections, grade the gaps, guide actions and to address the appropriate level of responsability. User friendly reporting formats, database and unicode for linkage were designed ex novo. Information flow was agreed with the Health District Authorities. After the learning period, staffs felt empowered about resolving gaps and less stressed advocating higher authorities. Conflicts lost harshness. Satisfaction was captured by a self-filled anonymous questionnaire in june 2018 (n = 80, 12 core questions, 0-4 likert scale, mean >3, SD < 1, median= 4, open sentences positives). Quality improvements of health care services were measured by the Ugandan Ministry of Health independently. Unclear targets, shortage of means, ineffective communication flows reduce quality and trigger frustration. Sustaining transparency, organizing communication flows and proceedings, sourcing staff’s experience could enhance success both in reaching targets and promoting relational health at workplace. Key messages Transparency, shared decisions, clear communication, awareness of the aims and mastership are able to reduce conflicts and misunderstandings, sustaining a healthier workplace relational environment. People spend 60 to 80% of their active time at workplace. Well designed tools, policies and information flows, could be effective health enhancer as well. Work style is a lifestyle.
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Musoke, David, Edwinah Atusingwize, Deborah Ikhile, Sarah Nalinya, Charles Ssemugabo, Grace Biyinzika Lubega, Damilola Omodara, Rawlance Ndejjo, and Linda Gibson. "Community health workers’ involvement in the prevention and control of non-communicable diseases in Wakiso District, Uganda." Globalization and Health 17, no. 1 (January 7, 2021). http://dx.doi.org/10.1186/s12992-020-00653-5.
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Abstract Background Community health workers (CHWs) are an important cadre of the global health workforce as they are involved in providing health services at the community level. However, evidence on the role of CHWs in delivering interventions for non-communicable diseases (NCDs) in Uganda is limited. This study, therefore, assessed the involvement of CHWs in the prevention and control of NCDs in Wakiso District, Uganda with a focus on their knowledge, attitudes and practices, as well as community perceptions. Methods A cross-sectional study using mixed methods was conducted which involved a structured questionnaire among 485 CHWs, and 6 focus group discussions (FGDs) among community members. The study assessed knowledge, perceptions including the importance of the various risk factors, and the current involvement of CHWs in NCDs, including the challenges they faced. Quantitative data were analysed in STATA version 13.0 while thematic analysis was used for the qualitative data. Results The majority of CHWs (75.3%) correctly defined what NCDs are. Among CHWs who knew examples of NCDs (87.4%), the majority mentioned high blood pressure (77.1%), diabetes (73.4%) and cancer (63.0%). Many CHWs said that healthy diet (86.2%), physical activity (77.7%), avoiding smoking/tobacco use (70.9%), and limiting alcohol consumption (63.7%) were very important to prevent NCDs. Although more than half of the CHWs (63.1%) reported being involved in NCDs activities, only 20.9 and 20.6% had participated in community mobilisation and referral of patients respectively. The majority of CHWs (80.1%) who were involved in NCDs prevention and control reported challenges including inadequate knowledge (58.4%), lack of training (37.6%), and negative community perception towards NCDs (35.1%). From the FGDs, community members were concerned that CHWs did not have enough training on NCDs hence lacked enough information. Therefore, the community did not have much confidence in them regarding NCDs, hence rarely consulted them concerning these diseases. Conclusions Despite CHWs having some knowledge on NCDs and their risk factors, their involvement in the prevention and control of the diseases was low. Through enhanced training and community engagement, CHWs can contribute to the prevention and control of NCDs, including health education and community mobilisation.
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Ray, Sunanda, and Robert Mash. "Innovation in primary health care responses to COVID-19 in Sub-Saharan Africa." Primary Health Care Research & Development 22 (2021). http://dx.doi.org/10.1017/s1463423621000451.
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Abstract Background: In May 2020, the African Journal of Primary Health Care and Family Medicine invited submissions on lessons learnt from responses to the COVID-19 pandemic from primary care providers in Africa. This included descriptions of innovations and good practices, the management of COVID-19 in district health services and responses of communities to the outbreak. Aim: To synthesise the lessons learnt from the COVID-19 pandemic in the Africa region. Methods: A thematic document analysis was conducted on twenty-seven short report publications from Botswana, Ghana, Nigeria, South Africa, Uganda and Zimbabwe. Findings: Eight major themes were derived from the data: community-based activities; screening and testing; reorganisation of health services; emergency care for COVID-19; maintenance of essential non-COVID-19 health services; caring for the vulnerable; use of information technology; and reframing training opportunities. Community health workers were a vital community resource, delivering medications and other supplies to homes, as well as following up on patients with chronic conditions. More investment in community partnerships and social mobilisation was proposed. Difficulties with procurement of test kits and turn-around times were constraints for most countries. Authors described how services were reorganised for focused COVID-19 activities, sometimes to the detriment of essential services and training of junior doctors. Innovations in use of internet technology for communication and remote consultations were explored. The contribution of family medicine principles in upholding the humanity of patients and their families, clear leadership and planning, multidisciplinary teamwork and continuity of care was emphasised even in the context of providing critical care. Conclusions: The community-orientated primary care approach was emphasised as well as long-term benefits of technological innovations. The pandemic exposed the need to deliver on governmental commitments to strengthening primary health care and universal health coverage.
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Wakida, Edith K., Moses Ocan, Godfrey Z. Rukundo, Samuel Maling, Peter Ssebutinde, Elialilia S. Okello, Zohray M. Talib, and Celestino Obua. "Adherence to clinical guidelines in integration of mental health services into primary health care in Mbarara, southwestern Uganda: a medical records review." International Journal of Mental Health Systems 15, no. 1 (July 15, 2021). http://dx.doi.org/10.1186/s13033-021-00488-6.
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Abstract Background The Ugandan Ministry of Health decentralized mental healthcare to the district level; developed the Uganda Clinical Guidelines (UCG); and trained primary health care (PHC) providers in identification, management, and referral of individuals with common mental disorders. This was intended to promote integration of mental health services into PHC in the country. ‘Common mental disorders’ here refers to mental, neurological and substance use conditions as indicated in the UCG. However, the extent of integration of mental health into general healthcare remains unknown. This study aimed to establish the level of adherence of PHC providers to the UCG in the identification and management of mental disorders. Methods This was a prospective medical record review of patient information collected in November and December 2018, and March and April 2019 at two health centers (III and IV) in southwestern Uganda. Data (health facility level; sex and age of the patient; and mental disorder diagnosis, management) was collected using a checklist. Continuous data was analyzed using means and standard deviation while categorical data was analyzed using Chi-square. Multivariable logistic regression analysis was performed to establish predictors of PHC provider adherence to the clinical guidelines on integration of mental health services into PHC. The analysis was conducted at a 95% level of significance. Results Of the 6093 records of patients at the study health facilities during the study period, 146 (2.4%) had a mental or neurological disorder diagnosis. The commonly diagnosed disorders were epilepsy 91 (1.5%) and bipolar 25 (0.4%). The most prescribed medications were carbamazepine 65 (44.5%), and phenobarbital 26 (17.8%). The medicines inappropriately prescribed at health center III for a mental diagnosis included chlorpromazine for epilepsy 3 (2.1%) and haloperidol for epilepsy 1 (0.7%). Female gender (aOR: 0.52, 95% CI 0.39–0.69) and age 61+ years (aOR: 3.02, 95% CI 1.40–6.49) were predictors of a mental disorder entry into the HMIS register. Conclusion There was a noticeable change of practice by PHC providers in integrating mental health services in routine care as reflected by the rise in the number of mental disorders diagnosed and treated and entered into the modified paper based HMIS registers.
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Ouma, Simple, Nazarius Mbona Tumwesigye, Rawlance Ndejjo, and Catherine Abbo. "Prevalence and factors associated with major depression among female sex workers in post-conflict Gulu district: a cross-sectional study." BMC Public Health 21, no. 1 (June 13, 2021). http://dx.doi.org/10.1186/s12889-021-11207-8.
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Abstract Background Female sex workers operating in conflict-affected settings could be at a much greater risk of major depression. However, the epidemiology of major depression in this population remains understudied. We aimed to determine the prevalence and the factors associated with major depression among FSWs in the post-conflict Gulu district in Northern Uganda. Methods We conducted a cross-sectional study among 300 randomly selected adult female sex workers in Gulu. We utilized a pre-tested semi-structured questionnaire, embedded with MINI 7.0.0, to gather information from each participant through face-to-face interviews. We collected data on socio-demographic characteristics, sex-work-related characteristics, alcohol and drug use, HIV status, and major depression. Then, data were entered into EPI INFO 7 and analyzed using logistic regression with the aid of STATA 14.0. Results The mean age (SD) of the study participants was 26.4 (± 6) years, 57.7% attained primary education, 51.7% never married, and 42.1% were living with HIV. The prevalence of major depression among FSWs in the district was 47.7%. In addition, the majority of the FSWs with major depression (91.0%) had either severe (50.4%) or moderate (40.6%) depressive symptoms. Independently, life stress (adjusted OR = 10.8, 95%CI: 5.67–20.57), living with HIV (adjusted OR = 2.25, 95%CI: 1.25–4.05), verbal abuse (adjusted OR = 2.27, 95%CI: 1.27–4.08), and older age (adjusted OR = 1.06, 95%CI: 1.01–1.12) all showed positive associations with major depression. Conversely, provision of sexual services from clients’ homes (adjusted OR = 0.50, 95%CI: 0.25–0.97), use of a non-barrier modern family planning method (adjusted OR = 0.44, 95%CI: 0.24–0.82), and daily intake of alcohol (adjusted OR = 0.50, 95%CI: 0.28–0.88) all showed negative associations with major depression. Conclusions There is a high prevalence of major depression among female sex workers in post-conflict Gulu. The high prevalence of major depression underscores the need for government and development partners to urgently and adequately address the mental health needs of female sex workers.