Browsing by Author "Katongole, Simon Peter"

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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, Robert; Onzima, DDM
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.
Assessment of the accuracy of malaria microscopy in private health facilities in Entebbe Municipality, Uganda: a cross-sectional study
(BMC Springer Nature, 2021-06-06) Mutabazi, Tobius; Arinaitwe, Emmanuel; Ndyabakira, Alex; Sendaula, Emmanuel; Kakeeto, Alex; Okimat, Paul; Orishaba, Philip; Katongole, Simon Peter; Mpimbaza, Arthur; Byakika‑Kibwika, Pauline; Karamagi, Charles; Nakayaga Kalyango, Joan; Kamya, Moses R.; Dorsey, Grant; Nankabirwa, Joaniter I.
Although microscopy remains the gold standard for malaria diagnosis, little is known about its accu‑ racy in the private health facilities in Uganda. This study evaluated the accuracy of malaria microscopy, and factors associated with inaccurate smear results at private health facilities in Entebbe Municipality, Uganda. Between April and May 2018, all patients referred for a malaria smear in 16 private health facilities in Entebbe municipality were screened, and 321 patients were enrolled. A questionnaire was administered to collect demographic and clinical information, facility-based smear results were recorded from the participant’s consultation notes, and a research slide was obtained for expert microscopy during exit interview. A health facility assessment was conducted, and information on experience in performing malaria microscopy was collected from all facility personnel reading smears and the data was linked to the participant’s clinic visit. The test positivity rate of malaria parasitaemia was 15.0% by expert microscopy. The sensitivity, specifc‑ ity and negative predictive value of the facility-based microscopy were high (95.8%, 90.1 and 99.2%, respectively). However; the positive predictive value (PPV) was low with 27/73 (63%) patients diagnosed with malaria not having the disease. Majority of the inaccurate results were from 2 of the 23 laboratory personnel reading the smears. The factors associated with inaccurate smear readings included being read by a technician; (1) who had less than 5 years’ experience in reading malaria smears (adjusted Odds Ratio [aOR]=9.74, 95% confdence interval [CI] (1.06–89.5), p-value=0.04), and (2) who was examining less than 5 smears a day (aOR=38.8, 95% CI 9.65–156, p-value<0.001). The accuracy of malaria microscopy in this setting was high, although one third of the patients diag‑ nosed with malaria did not have the disease. Majority of the errors in smear readings were made by two laboratory personnel, with the main factor associated with inaccurate smear results being low experience in malaria microscopy. In-service training may be sufcient to eliminate inaccurate smear results in this setting, and these private facilities would be ideal model facilities to improve the quality of malaria microscopy in Uganda especially in the public sector where accuracy is still poor
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, Robert DDM Onzima; 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’
Communities’ Willingness to Pay for Healthcare in Public Health Facilities of Nakasongola District, Uganda
(International Journal of Public Health Research, 2015-08-20) Dakoye, Damali; Anguyo, Robert Onzima; Govule, Philip; Katongole, Simon Peter; Ayiko, Rogers; Nabyonga-Orem, Juliet
Poor countries continue to register decreasing revenue to finance health care amidst rising demand with consequently growing out of pocket expenditure on health exceeding 35% of the total health care expenditure; this scenario is observed in more than three quarter of Sub-Saharan African countries. For Uganda, the situation is even worse with about half of the national health expenditure financed from out of pocket despite tax-based national health services. In response, Uganda’s Ministry of Health has placed health insurance at centre of financing health care in the medium term. This paper examines willingness to pay for health care in line with the planned policy of Uganda. We evaluated: willingness to pay for the health care in public health facilities; household characteristics associated with willingness to pay; how much households were willing to pay; and the preferred mode of payment. Methods: We interviewed 376 household heads or their representatives in four sub-counties of Nakasongola district for willingness to pay for the current or improved quality of health care in public health facilities. In order to explore how much the households were willing to pay per capita member of household per annum, we employed the contingency valuation method using the ‘open-ended’ bidding game. Results: Majority, 56.7% (199) of the respondents were not willing to pay for health care in public health facilities at the current level of quality. Willingness to pay grew from 43.3% (152) to 83.5% (293) for improved quality of care in public health facilities. Major operations, in-patient therapeutic care and health facility deliveries in that order were the services communities were most willing to pay for if quality of care matched their expectation. The median willingness to pay was Ugandan shillings 4,888 ($1.56) (range 0-10,000 [$3.19]) and once-annual prepayment was preferred by majority of respondents. Female-household headship, high-level of education of household head and belonging to lower income quintiles were positively associated with willingness to pay. Conclusion: The communities in Nakasongola district are willing to pay for health care in public health facilities provided the quality of care is improved. Given the low median amount of willingness to pay and the fact that persons from poor households were more willing to pay, planners of Health Insurance programs should devise progressive premium calculation mechanisms and further plan for government subsidy in order to take care of the poor.
The impact of COVID-19 on mental health of frontline health workers in Ghana and Uganda
(Science Direct-Elsevier, 2021-06-18) Katongole, Simon Peter; Yaro, Peter; Bukuluki, Paul
The COVID-19 pandemic has had devastating effects on health systems at global, national, and subnational levels. During disease outbreaks, the human resources for health are among the most affected building blocks of the healthcare system. However, there is limited data on the experiences of frontline health workers during the COVID-19 pandemic and their implications for their psychosocial wellbeing. We conducted in-depth interviews with health workers in two hospitals in Uganda and Ghana that have been at the helm of treating people who are being treated for COVID-19. This chapter discusses how COVID-19 has impacted the mental health and psychosocial wellbeing of health workers in two African countries, Uganda and Ghana. It also discusses the mechanisms employed by health workers to cope with COVID-19 and its consequences. In addition, we also discuss existing strategies the health systems of these countries have developed and implemented to promote the mental health and psychosocial wellbeing of health workers managing the COVID-19 pandemic in hospitals in Uganda and Ghana. We conclude by calling upon governments and the international community to invest in promoting the mental and psychosocial wellbeing of health workers as well as people who are being treated for COVID-19 affected by outbreaks particularly COVID-19.
Improving Partograph Documentation and Use by Health Workers of Bwera Hospital
(Open Science, 2015-06-20) Katongole, Simon Peter; Govule, Philip; Masika, Mary Aliona
In this action based research we undertook a pragmatic quality-improvement approach to the research. This article describes improvements realized when an action research was carried out on maternity department in Bwera Government hospital Kasese district. We describe how practice research engagement was employed in the maternity department to contribute to health service improvement. The action research was carried between the months of June to August 2014, the study aimed at improving partograph documentation and use by midwives and doctors working in the department. The study used an exploratory, descriptive process improvement research to determine the most pressing problem on the department that required urgent improvement. Problems identified included inadequate infection prevention, poor partograph use and documentation, Comprehensive Emergency Obstetric and Neonatal Care (CEmONC), and failure to adhere to the 5S principles. Through pairwise ranking, inadequate partograph documentation and use by midwives and doctors while assisting mothers to deliver was the prioritized problem that required urgent improvement. Basing on guidelines adopted from the Ministry of Health by Engender Health Project on correct use and documentation of partograph, the number of deliveries conducted and had all the 18 (100%) indicators of the partograph monitored and documented stood at 8.3%. This, therefore, led to training all midwives and doctors working on maternity ward on correct use and documentation of a partograph, increase attachment of partographs to clients’ files and address the practice of leaving partographs blank. The research targeted to increase the percentage of mothers monitored in labour by the correct documentation and use of the partograph. Monitoring of mothers through correct documentation and use of the Partograph at maternity department improved to 89.3%. Marked changes were realized in attaching partographs on clients’ files from 96% to 99% and reduction of partographs left blank from 8% to 3%. It is therefore recommended that clinical leadership, continuous professional development and support supervision on partograph use and documentation be emphasized in
Malaria treatment health seeking behaviors among international students at the University of Ghana Legon
(PLOS, 2023-10-26) Lwenge, Mathias; Govule, Philip; Katongole, Simon Peter; Dako-Gyeke, Phyllis
Appropriate management of malaria demands early health seeking behaviour upon suspicion of malaria-like symptoms. This study examined malaria treatment seeking behaviour and associated factors among international students at University of Ghana. The study used a cross-sectional and quantitative approach. Data collection was undertaken using a structured questionnaire administered on a random sample of 264 international students. Data obtained on malaria treatment and factors influencing treatment behaviors were analyzed using IBM, SPSS Statistics version 22. Associations between individual characteristics and Malaria treatment seeking behavior was assessed by Pearson Chi-square(X2) test of independence. Binary logistic regression model was built using a backwards Wald approach, with variables retained at Wald p-value <0.05. The findings show that 35% of the respondents obtained self-prescribed antimalarial at their utmost first choice of Malaria treatment. At bivariate level, a significant relationship between Malaria health-care seeking behaviour and:- Respondents continent, X2(1, N = 264) = 7.936, p = .005; Service accessibility, X2(1, N = 264) = 7.624, p = .006; Wait time, X2(1, N = 264) = 22.514, p <0.001; Treatment cost, X2(1, N = 264) = 97.160, p <0.001; Health insurance, X2(1, N = 264) = 5.837, p = 0.016, and Perceived staff attitude, X2(1, N = 264) = 18.557, p < 0.001. At multivariable analysis, inappropriate malaria health seeking behaviours was associated with low perceived service accessibility as (≥30mins) (aOR = 6.67; p<0.001), perceived long wait time (≥30mins), (aOR = 5.94; p = 0.015), perceived treatment cost affordability (<15 GHC) (aOR = 19.88; p<0.001) and age group: -34-41years (aOR = 8.83; p<0.001). There were widespread inappropriate health-care seeking behavior for Malaria treatment among international students. Improving accessibility to malaria treatment services, reducing wait time at health facilities and the treatment cost will address inappropriate malaria treatment health seeking behaviours among the international students.
Management of hospital security in general hospitals of Southwestern Uganda
(International Journal of Public Health Research, 2015-06-20) Katongole, Simon Peter; Bigira, Sebakiga Ezra
The management of security varies in different organizations including hospitals, and security is one of the major support services needed for ensuring a safe environment of care. This study determined the management of security in general hospitals in Southwestern Uganda. A descriptive-cross-sectional study, which employed both quantitative and qualitative methods of data collection and analysis, was carried out. Common security concerns were theft, assaults, workplace violence and elopement with generally low chances of security concerns happening and poor preparedness to handle them in case they occurred. Only two out of six hospitals fairly met the security standards with identified gaps like lack of security guidelines, security plans, security committees, and non-availability of training opportunities for security personnel. Hospital managers and other policy makers involved in the management of hospital security should work together and address the security gaps existing in general hospitals in order to improve on the management of security.
Medical Litigation in Hospitals in Kampala, Uganda
(International Journal of Public Health Research, 2015-07-20) Gakumba, Eva Kadimba; Katongole, Simon Peter; Bikaitwoha, Everd Maniple
Seeking legal redress for harm sustained while receiving medical care is common in some developed countries but less common in most developing countries. However, unconfirmed reports suggest that litigation is on the increase even in developing countries like Uganda. Litigation influences the behaviour of both health care workers and hospital managers, with significant consequences for patients and the entire health system. Given the dearth of publications on the extent of medical litigation in developing countries, this exploratory study sought to determine the prevalence, trends, determinants and effects of medical litigation on medical practice in hospitals in Kampala. Using a mixed methods approach, ten Kampala hospitals belonging to the government, private not-for-profit (PNFP) and for-profit (PFP) organisations that had been in operation for at least 5 years were purposively studied. Participants included medical directors, officials from courts of judicature, health professional bodies, and officials from health care consumer organisations. The study revealed that medical litigation in Kampala was still minimal but increasing steadily. Surgeons and Obstetricians / Gynecologists were the specialties most at risk of medical litigation. Significant factors responsible for the increase in medical litigation trends were: heavy workload; increased exposure to medical information; and increased awareness on patient rights. Medical litigation has led to improvement in quality of health care, huge financial burden to the health care providers, and suspension or outright withdrawal of health workers from medical practice. Efforts to reduce litigation include continuous professional development, better staff recruitment practices and strict enforcement of standard operating procedures. There is need for dialogue between the patient safety stakeholders, staff training on patient-centred care and training of managers on the implications and processes of medical litigation.
Missed Opportunity for Neonates to Live: A Cross-sectional study on Utilization of Peri-natal Death Audits to address the Causes of Peri-Natal Mortality in District Hospitals of East–Central Uganda.
(Students journal of health research Africa, 2022-09-10) Waako, Christopher Knox; Nanyingi, Miisa; Katongole, Simon Peter; Atuhairwe, Christine; Konso, Jennipher Mariam; Maniple, Everd
Aim: To assess the utilization of PDAs in addressing the avoidable causes of perinatal mortality in the eastern region of Uganda. Methodology: A cross-section design using a mixed method was conducted between 2014-2015 at Iganga, Bugiri, and Kamuli general hospitals in the East-Central region of Uganda. The interviews involved 115 health workers who included Doctors, Nurses/Midwives, Clinical officers, and Laboratory and Theatre staff. These were drawn from four departments including the Maternity ward, Outpatient department, Theatre, and paediatric ward. Hospital top and departmental managers formed the key informants for this study. Annual reports for the period 2009/10-2012/13 were reviewed. In addition, monthly reports for the calendar year 2013 together with patients’ clinical case notes and patients’ registers were also reviewed to determine the magnitude and causes of perinatal mortality. Factors contributing to perinatal death were assessed and categorized into foetal, maternal, and health facility factors. Results: Results revealed a high and rising perinatal mortality rate of 70/1,000 live births and a decreasing maternal mortality ratio of 363/100,000 live births. Most perinatal deaths were fresh stillbirths 48/88 which occurred during the intrapartum period and the majority of early neonatal death was due to birth asphyxia. None of the health facilities was conducting perinatal death audits and the quality of data used for perinatal death audits was inadequate and was scored poorly. Challenges hindering utilization of perinatal death audits included: lack of staff sensitization and training, work overload, lack of motivation, fear of blame and litigation, political interference, and lack of support from the community. Conclusion: There was a high prevalence of perinatal deaths in east-central Uganda yet none of the hospitals was conducting perinatal death reviews. Recommendations: Health workers should be trained on perinatal death audit tools and guidelines and the records departments are revitalized with tools and personnel for effective data management.
Perceptions of Health Workers and Managers on the Use of Non-Monetary Human Resource Motivation Tools in General Hospitals of Central Uganda
(Open Science, 2015-08-30) Katongole, Simon Peter; Mugisha, John Francis; Anguyo, Robert; Bikaitwoha, Everd Maniple; Wampande, Lillian Nantume
World over, there is a driving force to create a health care workplace that motivates, maintains and obtains the best out of health workers. In order to achieve this, non-monetary tools can be employed by health managers in hospital settings. Therefore, a study was carried out in six Ugandan general hospitals to establish the perceptions of health workers on the use of non-monetary human resource motivation tools and to examine the contribution of these tools to employees’ motivation. A cross-sectional qualitative study was employed. Key informant interviews with three District Health Officers and 15 top hospital managers were conducted. Six focus group discussions, one in each hospital where also conducted with participating health workers derived from professional groups such as medical officers, enrolled/registered midwives and nurses and allied health professionals. Health workers were interviewed on prevailing practice, adequacy, experience, functioning and views on core non-monetary human resource motivation tools such as training, supervision, performance assessments, and management. Critical incidents were nonmonetary human resource motivation tools had influenced the motivation of some health workers were identified. The use of core non-monetary human resource tools such as continuous medical education, communication between health workers, taking part in decisions of the hospital and organizing social functions were well perceived by the respondents. Promotion of health workers, recognizing best performers, supervision, training and workshops were not well perceived. Health workers were mainly: motivated by the good work relationships and they were mainly demotivated by the poor working conditions. There is a need to have urgent attention on factors which seem to affect the effective use of the non-monetary human resource tools. The factors include; improving working conditions and staffing to reduce workload and avail enough resources to the workers to be motivated carry out their work.
Prevalence and drug susceptibility of isolates of urinary tract infections among febrile under-fives in Nsambya Hospital, Uganda
(Open Science Journal of Clinical Medicine, 2015) Katongole, Simon Peter; Ocokoru, Christine; Onzima, Robert Anguyo DDM; Govule, Philip
Background: Urinary tract infections remain a silent cause of morbidity and complications among under-fives due to its nonspecific presentation and incapacity of most health facilities in developing countries to diagnose it. Earlier studies present different prevalence of urinary tract infections among children. This study aimed to document prevalence and drug susceptibility patterns of isolates of bacterial urinary tract infections among under-fives in Nsambya hospital, Uganda. Methodology: We conducted a descriptive cross-sectional survey among 302 under-fives who presented in paediatric ambulatory care department of Nsambya hospital with fever (axillary temperature of >37.5°C or by history); and with no history of antibiotic therapy within three days preceding hospital visit. Midstream urine samples collected using bag and bottle collection (depending on age of child) were subjected to culture. We further subjected culture-positive urine samples to systematic bacteriologic and biochemical tests in order to identify the organisms in the colonies before performing drug susceptibility tests. Results: We found urinary tract infection prevalent in 26.8% of the under-fives. Bacterial isolates responsible for the infections were Proteus (39.5%), Escherichia coli (32.1%), Staphylococcus aureus (14.8%), Klebsiella spp. (6.2%), Staphylococcus haemolyticus (2.5%), Staphylococcus intermedius (2.5%), Citrobacter (1.2%) and Morganella (1.2%) in that order. The pathogens exhibited high-level of resistance to commonly used antibiotics like Cotrimoxazole, Amoxicillin, Nalidixic Acid, Nitrofurantoin, Gentamicin, Erythromycin, Chloramphenicol, Ampicillin, Ciproflaxin, Tetracycline and Azithromicin while the isolates showed no resistance to pharmaco-enhanced Amoxicillin and oral Cefatoxime. Conclusion: Prevalence of UTI among febrile under-fives in Nsambya hospital is higher than reports from majority of earlier studies. Similarly, the commonest bacterial isolates associated with UTI among under-fives in Nsambya hospital deviates from most studies in developing countries that majorly report Escherichia coli as the leading cause of UTI in this age category. The observed resistance patterns associated with common antibiotics in our study are in line with the current changing patterns of microbial-antibiotic resistance threatening not only the developing world but the entire glob.
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, Robert. DDM Onzima; 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, Robert DDM Onzima
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, Robert DDM; 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.