Browsing by Author "Anguyo DDM Onzima Robert"

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Application of workload indicators of staffing needs (WISN) in determining health workers' requirements for Mityana general hospital, Uganda
(International Journal of Public Health Research, 2015-08-30) Govule Philip ; Mugisha John Francis ; Katongole Simon Peter ; Bikaitwoha Maniple Evard ; Nanyingi Miisa ; Anguyo DDM Onzima Robert
With reducing number of health workers amidst increasing disease burden, ever increasing population and limited resources, health systems are faced with challenges of providing adequate and quality health care globally. The application of provider-population ratio or fixed staff establishments have overtime, not matched the changing human resource needs of health care organizations. This study aimed to estimate human resource requirements of Mityana hospital basing on workload as an alternative to the existing approaches. Methodology: We employed descriptive cross-sectional design and the Workload Indicator of Staffing Needs (WISN) methodology. We utilized focus group discussion, observation and document review to obtain information from key informants; generated annual service statistics from the hospital’s records. The quantitative data were analyzed using the WISN software and spread sheet. Results: All the cadres studied had the same hours of work in a year (1,664), except nursing assistants whose annual available working time was1,696 hours. All the cadres were experiencing additional workload due to use of their time for activities other than their primary duties. Medical officers used more than 50% of their time for such (non-primary) activities compared to the laboratory staff (15%). As a result, the calculated WISN staff requirements were very high compared to the existing staff levels. Mityana hospital had 44% of the posts filled for the studied cadres. The nurses and midwives had the highest calculated requirements (72 and 45 respectively) and the highest staff positions filled (57% and 84% respectively) making them experience the lowest work pressure (49% each). The highest work pressure was experienced by medical officers and medical clinical officers (82% each). Conclusion: The study reveals shortages in health workforce in Mityana hospital. Non-primary activities contributed to work pressure in different units of the hospital, resulting into long hours of shifts which could have compromised quality of health care. This method (WISN) estimates staffing requirements based on actual service provision. Stakeholders facing human resource challenges and scarcity can employ it in prioritizing health cadres for recruitment and deployment based on existing work pressure.
Assessment of safe motherhood health service coverage, birth defects detection and child disability prevention using lot quality assurance sampling in Central Uganda
(East African Health Research Commission, 2023) Akankwasa Edith; Kamya Willy; Sendijja Moses; Mudoola Janet; Lwenge Mathias; Anguyo DDM Onzima Robert; Kasozi Daniel; Byansi Peter; Katongole Simon Peter
It is crucial to have satisfactory coverage of safe motherhood services in order to prevent birth defects and child disabilities. Mildmay Uganda Institute of Health Sciences (MIHS) implemented a safe motherhood project aimed at preventing birth defects and child disabilities. Three years after the project’s implementation, a rapid cross-sectional health facility survey was conducted in 4 districts of central Uganda to assess the coverage of key safe motherhood and early childhood services. The Lot Quality Assurance Sampling approach was used to assess coverage of 16 indicators in the areas of ANC, skilled birth attendance, early childhood care, postnatal care, and knowledge about child disability prevention. A Decision Rule was set at 80% upper threshold to classify the performance of health facilities at the district level. The survey found that there was variation in performance across indicators and districts. All districts achieved the 80% coverage target in ANC first visit, mothers who received at least two doses of Fansidar for intermittent preventive treatment of malaria in pregnancy, and mothers with knowledge of the action to take in case they suspect childhood disability. Folic acid supplementation during pregnancy and screening for birth defects using the Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) score had overall coverage above the target, but one district each had coverage below target in each of these 2 indicators. The coverage target was not reached in the rest of the survey indicators in each of the districts. Well-performing districts, especially in indicators with inconsistent performance, offer valuable insights for learning and adapting interventions in districts that do not meet the desired coverage of those particular indicators. Considering the disparities in performance among different indicators and districts, project planners should adopt, modify and implement successful strategies in districts and indicators that perform well. By doing so, they can enhance the performance of under performing districts or indicators.
Common Medical Errors and Error Reporting Systems in Selected Hospitals of Central Uganda
(International Journal of Public Health Research, 2015-08-30) Katongole Simon Peter; Anguyo DDM Onzima Robert; Nanyingi Miisa; Nakiwala Stella Regina
Medical errors are under studied in the developing world, therefore, this study set out to identify common errors committed during provision of health care and error management systems in the hospitals with reference to central Uganda. This was a descriptive cross sectional study carried out between January 16th and January 22nd 2012 in four hospitals in central Uganda (2 Public hospitals and 2 Catholic Private not for profit hospitals). A total of 160 health workers participated in the study. Respondents were interviewed the on errors they had committed or witnessed happening in their hospitals during the 3 months preceding this study. Patients’ records of the three months preceding the study were also reviewed to identify the common medical errors that had been committed. Of the six hundred and eighteen records that were reviewed’ medication (17.2%) and diagnostic (40.5%) were the commonest medical errors. Health workers too mentioned medication (58%) and diagnostic (53%) as the commonest errors they had witnessed or committed in the hospitals. No formal error reporting system existed in all the hospitals. Errors committed or witnessed were mainly disclosed to supervisors and/or colleagues during handover of duty and informal interactions. Lack of feedback, fear of punishment and litigation were the major impediments to disclosing errors. Error reporting importance was highly perceived by health workers. Instituting a mechanism of formal error reporting and management should be considered by the hospitals and the ministry of health so that errors can be used as a mechanism for ‘prevention by past experience’
Determining Healthcare Workforce Requirements for Kuluva Hospital in West Nile-Uganda, using the Workload Indicators of Staffing Need (WISN)
(Research Square, 2023-04-29) Anguyo DDM Onzima Robert; Govule Philip; Apangu Titus; Harogha Alan; Wibale Wilson; Debo Ronald; Ambayo Richard; Lulua Awudo Jimmy; Maryekmungu Immaculate; Likico Bayoru Aziku Celina; Nanyingi Miisa; Karengera Innocent
Health workforce shortage is a major threat to global public health with a greater implication for low resourced countries. The right placement of the available staff in many health facilities remains a challenge due to inadequate information on exact workload and work pressure that staff undergo in course of work. This study aimed to determine the need for key health workforce cadre in Kuluva hospital using Workload Indicators of Staffing Need (WISN) methodology. The study followed a predominantly quantitative approach of Workload Indicator Staffing Needs (WISN) methodology. We held a meeting with hospital management to understand policy issues and procedures. The key staff were interviewed in departments, available records reviewed, practices observed to establish the available working time, activity standards and time taken to perform other supportive activities. Service statistics was generated from HMIS data of 2016/17. Data was analyzed manually using calculator and Microsoft Excel spreadsheet. All cadre categories had the same available working time of 1,504 hours in a year with 105 staff of the studied cadres required to perform all activities in Kuluva hospital based on WISN calculation. Although overall work pressure was 30%, 5 out of 7 staff cadre categories experienced work pressure of varying degrees – medical officers (70%), laboratory staff (70%) and clinical officers (60%) were most affected compared to nurses (30%) and midwives (10%). There was perfect number of anesthetists but surplus nursing assistants than needed by the hospital. Amidst shortage, the critical cadres still spent significant time on non-professional activities; medical officers (24%) and midwives (25%). These findings can provide insight into the management of Kuluva hospital to address the current disparities in the health workforce in terms of numbers and skill mix for continuous improvement of health service delivery to the population it serves.
Quality and Use of Routine Healthcare Data in Selected Districts of Eastern Province of Rwanda
(International Journal of Public Health Research, 2016-05-03) Karengera Innocent; Anguyo DDM Onzima Robert; Katongole Simon Peter; Govule Philip
Strengthening of Health Management Information System (HMIS) is becoming an unavoidable task for most health systems in the World. As part of the strengthening (of HMIS), it is imperative that stakeholders undertake periodic studies on HMIS-data quality so as to gain insight into the level of quality and cause corrective action. This study evaluated the quality of HMIS, factors influencing quality (of HMIS), use of data generated from HMIS and factors influencing use of data in 3 districts of Eastern Province of Rwanda. We employed a descriptive cross-sectional study design focusing on 9 months from 1st July 2012 to 31st March 2013. To achieve this we conducted HMIS data quality assessment through checking of presence of selected registers and client/patients’ cards, deviations between reported patient statistics and those in the appropriate registers, reports with at least 95% of the data fields well filled, expected reports received at the receiving hospitals, reports received by due date and evidence of data use from a set of criteria. We further conducted key informants interviews with the health facility managers and records officers on factors influencing the observed data quality; use of data and associated factors. We found that though every ‘register of interest’ was available in all the health facilities, client/patients’ cards experienced severely stock out over the months under study. Low proportion of health facilities attained the a priori for availability of ANC cards (58.0%), Partograms (56.8%), Child Health Cards (59.5%), Family Planning user cards (78.1%) and Outpatient medical forms (57.4%). High proportion of health facilities had good quality of (accurate) health facility reports (73.3%) and those in the electronic data base (70.6%). Similarly, high proportion of health facilities met the quality standard for content completeness (97.6%) in addition to high proportion of expected reports received at the receiving hospitals (97.7%). The overall timeliness of reporting of HMIS monthly reports stood at 93.8%. Data were rarely used in the health facilities and this was majorly enhanced by the top-down approach to setting of targets and planning. We concluded that levels of data accuracy, completeness and timeliness in the situation of Rwanda did not match the rhetoric that data quality in health systems in developing countries is poor. The few lapses identified could have been associated with factors we did not statistically verify. Use of data in our study health facilities was inadequate and the self-reported use (of data) could not be backed by evidence from our observations. The top-down nature of planning greatly prevented the operational-level managers from using data.
Relationship Between Management Practices and Employee Absenteeism in Public General Hospitals of East-Central Uganda
(International Journal of Public Health Research, 2015-11-17) Wananda Irene; Byansi Peter Kayiira; Govule Philip; Katongole Simon Peter; Wampande Lillian Nantume; Anguyo DDM Onzima Robert
Effective management practices play a pivotal role in influencing positive behavior among employees at the work place [1]-[2]. Absenteeism of employees signals organizational ill health. Studies indicate that management practices can negatively or positively influence the employee absence rate in an organization [3]. This study assessed the relationship between management practices and health worker absenteeism in public general hospitals in East Central Uganda. It was prompted by the findings of Medicines and Health Services Delivery Monitoring Unit [4] that health worker absenteeism was rampant in Uganda. The study objectives were: to find out the magnitude and causes of health worker absenteeism in public general hospitals in East Central Uganda, establish the relationship between performance management practices and health worker absenteeism, establish the relationship between attendance and absence management practices and absenteeism, finally to establish the relationship between employee motivation and absenteeism. The study employed a mixed research design. Data were collected from 46 key informants, 220 health workers and 3 focus group discussions (FGDs). An absenteeism tracking tool was also used as a measure of health worker absenteeism. Descriptive statistics, frequency distributions and logistic regression were employed for data analysis alongside content analysis. Findings revealed that socio-demographic factors, performance management practices; attendance and absence management practices; and employee motivation practices did influence absenteeism. We concluded that Magnitude of absenteeism is still of management importance (influenced by management practices and socio-demography) and varied by hospital, time of assessment and day of the week. The implementation of management practices varied from one hospital to another – strengthening the performance management practices; attendance and absence management practices; and employee motivation practices while addressing the socio demographic characteristics (that predict absenteeism) along the continuum of the hierarchy of needs could further reduce absenteeism.
The State of Mortuary and Mortuary Services in Public Health Facilities of South Western Uganda
(International Journal of Public Health Research, 2015-11-10) Kazungu James ; Nanyingi Miisa ; Katongole Simon Peter ; Anguyo DDM Onzima Robert; Wampande Lillian Nantume
Mortuaries and mortuary services are very crucial support services to healthcare delivery. Information on the status of mortuary services in Uganda is largely missing. This study therefore was carried out to assess the status and factors associated with the prevailing status of mortuary services. A descriptive cross-sectional study that employed both qualitative and quantitative methods of data analysis was carried out in South Western Uganda. Two regional referral hospitals, four district hospitals and 38 public health centre IV’s were studied. Data in these health facilities were obtained through observation, interviewing the managers of the health facilities and personnel directly responsible for the running of mortuary services about the state of and functionality of mortuaries in the facilities they headed. Out of all the health facilities studied, Nineteen (19/44, 43%) did not have mortuaries at all while 21/25 (84%) facilities’ mortuaries, were ranked to be in a fair state. Out of the health facilities with mortuaries, Nineteen (19/25, 76%) were poorly equipped with instruments required in a mortuary.Most mortuaries did not have adequate and trained human resources. As a result, the mortuary and mortuary services are under utilized in the health facilities in the region and are mostly used as dumping and storage centres for corpses that are picked from the streets by police and corpses that are unclaimed for by relatives. The functionality of mortuaries in the area studied and in the whole country as well should be enhanced by the Ministry of health and local governments in the area. When mortuaries are functionalized, the public should be sensitized on the services offered and the need to utilize the mortuaries so as to undo the inefficiencies delineated in this study.