Browsing by Author "Abaasa, Andrew"

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    Assessment of quality of care among in-patients with postpartum haemorrhage and severe pre-eclampsia at st. Francis hospital nsambya: a criteria-based audit
    (BioMed Central Ltd, 2017-01-13) Lumala, Alfred; Sekweyama, Peter; Abaasa, Andrew; Lwanga, Humphrey; Byaruhanga, Romano
    Background: The maternal mortality ratio of Uganda is still high and the leading causes of maternal mortality are postpartum haemorrhage (PPH), severe pre-eclampsia and eclampsia. Criteria-based audit (CBA) is a way of improving quality of care that has not been commonly used in low income countries. This study aimed at finding out the quality of care provided to patients with these conditions and to find out if the implementation of recommendations from the audit cycle resulted in improvement in quality of care. Methods: This study was a CBA following a time series study design. It was done in St. Francis Hospital Nsambya and it involved assessment of adherence to standards of care for PPH, severe pre-eclampsia and eclampsia. An initial audit was done for 3 consecutive months, then findings were presented to health workers and recommendations made; we implemented the recommendations in a subsequent month and this comprised three interventions namely continuing medical education (CME), drills and displaying guidelines; a re-audit was done in the proceeding 3 consecutive months and analysis compared adherence rates of the initial audit with those of the re-audit. Results: Pearson Chi-Square test revealed that the adherence rates of 7 out of 10 standards of care for severe pre-eclampsia/eclampsia were statistically significantly higher in the re-audit than in the initial audit; also, the adherence rates of 3 out of 4 standards of care for PPH were statistically significantly higher in the re-audit than in the initial audit. Conclusion: The giving of feedback on quality of care and the implementation of recommendations made during the CBA including CME, drills and displaying guidelines was associated with improvements in the quality of care for patients with PPH, severe pre-eclampsia and eclampsia
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    Trends of Reported HIV Sexual Risk Behaviour and HIV Incidence Among Fisher Folk in Uganda Receiving Clinic-Based Routine HIV Counseling and Testing
    (2009) Ndibazza, Juliet; Asiki, Gershim; Mulondo, Jerry; Price, Matthew Andrew; Fast, Patricia; Kamali, Anatoli; Bahemuka, Ubaldo Mushabe; Abaasa, Andrew; Ruzagira, Eugene; Kibengo, Freddie Mukasa
    HIV counseling and testing (HCT) has been shown to reduce HIV risk behaviorandis central to HIV prevention programs. We investigated risk behaviorand HIV incidenceTrendsin a fisher folkcohort on Lake Victoria, Uganda. HIV negative volunteers aged 18–49 years, at high risk of HIV infection and willing to undergo HCT were enrolled. Atevery quarterly visit, they received HCT. Condoms and STI treatment were also provided.Risk behaviordata on alcohol consumption before sex, multiple or new sex partners, condom use and exchange of gifts for sex in the past 3 months were collected at baseline and every 6 months for 2 years. We fitted multilevel logistic regression models to investigate the trends.A total of 428 (63% men) volunteers, mean age 28 years were enrolled. There were significant reductions in reported risk behaviorsover the 2-year follow-up. The proportion reporting ‡ 2 partners decreasedfrom 80% at baseline to 45% at month 6 and to 43% at month 24 for males; for females the decrease was from 42% at baseline to 13% at month 6 and to 6% at month 24; P < 0.01). Similarly there were significant reductions among men (P = 0.01) reportingnew partners but of borderline statistical significance among females (P = 0.09). In both sexes there were significant decreases in reported non-condom use, transactional sex and in having sex when drunk. HIV incidence (in brackets 95% CI) reduced from 8.2/100 person years (5.1-13.5), to 7.3 (5.0-10.6), 6.5 (4.6-9.1) and 6.0 (4.3-8.3) at 6, 12, 18 and 24 months respectively (p = 0.21). In this study therewas a substantial reduction in self-reported risk behaviour in the first 6 months and marginal reduction in the later period. However, a modest HIV incidence reduction was observed. This calls foran urgent need for combination prevention strategies in this population.Key Words: Sexual Risk Behaviour, HIVIncidence, FisherFolk, Clinic-based Routine, HIV Counseling and Testing