Browsing by Author "Karengera Innocent"

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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 Health Information Systems Data in the Eastern Province of the Republic of Rwanda.
(Uganda Martyrs University, 2012) Karengera Innocent
KARENGERA INNOCENT (2012-M121-10009) Quality and use of Health Information Systems Data in the Eastern Province of the Republic of Rwanda Health data is continuously generated in the primary health facilities and fed in the country‟ health systems to facilitate health situation and trends analysis, support patient and health facility management, provide early warning in case of epidemics, support and stimulate research and enable planning with optimal resource allocation. To be of use, data has to be of quality. To be of benefit, data has to be used by decision makers, policy makers and health service providers at both policy and operational levels to improve health service delivery. Many researchers have described health data in developing countries as of poor quality and insufficiently or not used at all. This study assesses health data quality in terms of availability of source documents, accuracy, content completeness, completeness and timeliness of reporting. The factors influencing data quality have been identified and the level of data use established. Furthermore, the factors influencing data use in the health facilities of the three districts of Bugesera, Kayonza and Rwamagana in the eastern province of the Republic of Rwanda have been identified as a basis for improving health service delivery. 8 The study tries to answer four research questions; what is the level of data quality in the health facilities of Bugesera, Kayonza and Rwamagana districts? What are the factors influencing data quality in the health facilities of Bugesera, Kayonza and Rwamagana districts? What is the level of data use in the health facilities of Bugesera, Kayonza and Rwamagana districts? and what are the factors influencing data use in the health facilities of Bugesera, Kayonza and Rwamagana districts? A descriptive cross-sectional study design has been used with qualitative and quantitative approaches to data collection and analysis. The study population were the health centres in Bugesera, Kayonza and Rwamagana districts and the study unit was a health facility in the same districts. The Kish Leslie formula for sample size of infinite population was used for simple random sampling to get the sample size of the health units and later adjusted using the Cochran formula for sample size of finite population. The three districts of Bugesera, Kayonza and Rwamagana in the eastern province were purposively selected because they are adjacent hence convenience sampling. The three districts have many things in common with other districts in the province with respect to the infrastructure, personnel, disease burden and accessibility. Four district hospitals in the three districts of Bugesera, Kayonza and Rwamagana districts (Kayonza has two district hospitals) were excluded because they do not offer most of the key indicator services in this study like ANC, family planning (they offer surgical methods only) and vaccination. These services are offered in the primary level health facilities. The findings show that in majority of the health facilities data quality was good: availability of source documents, accuracy1, accuracy2, content completeness, completeness and timeliness of reporting stood at 61.9%, 73.3%, 70.6%, 97.6%, 97.6% and 93.9% respectively with overall quality of 82.3%. However, in most health facilities data use was inadequate. The study recommends that the following issues should be worked upon: deficient staff computer skills, lack of ownership of data, poor quality data, shear negligence, lack of feedback and work overload. These should be addressed by the Ministry of Health and the district hospitals in order to enhance good use and complete the data management cycle in the three districts. Key Words: Quality, Health Information Systems, Data, Eastern Province Republic, Rwanda
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.