Browsing by Author "Mugagga Kaggwa"

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Feasibility and acceptability of integrating hepatitis B care into routine HIV services: a qualitative study among health care providers and patients in West Nile region, Uganda
(BMC Springer Nature, 2023-01-20) Mutyoba Joan Nankya; Wandera Claude; Ejalu David; Seremba Emmanuel; Beyagira Rachel; Amandua Jacinto; Mugagga Kaggwa; Kambugu Andrew; Muganzi Alex; Easterbrook Philippa; Ocama Ponsiano
Despite facing a dual burden of HBV and HIV, Africa lacks experience in ofering integrated care for HIV and HBV. To contextualize individual and group-level feasibility and acceptability of an integrated HIV/HBV care model, we explored perspectives of health care providers and care recipients on feasibility and acceptability of integration. In two regional hospitals of West Nile region, we performed a demonstration project to assess feasibility and acceptability of merging the care of HBV-monoinfected patients with existing HIV care system. Using interviews with health care providers as key informants, and 6 focus groups discussions with 3 groups of patients, we explored feasibility [(i)whether integration is perceived to ft within the existing healthcare infrastructure, (ii) perceived ease of implementation of HIV/HBV integrated care, and (iii) perceived sustainability of integration] and acceptability [whether the HIV/HBV care model is perceived as (i) suitable, (ii) satisfying and attractive (iii) there is perceived demand, need and intention to recommend its use]. We audio-recorded the interviews and data was analysed using framework analysis. The following themes emerged from the data (i) integrating HBV into HIV care is perceived to be feasible, ft and benefcial, after making requisite adjustments (ii) integration is acceptable due to the need for both free treatment and anticipated collaboration between HIV and HBV clients in terms of peer-support (iii) there are concerns about the likely rise in stigma and the lack of community awareness about integrated care. The integrated HIV/HBV care model is feasible and acceptable among both providers and recipients. Necessary adjustments to the existing care system, including training, for community sensitization on the reasons and signifcance of integration are required.
Integrating hepatitis B care and treatment with existing HIV services is possible: cost of integrated HIV and hepatitis B treatment in a low-resource setting: a cross-sectional hospital-based cost-minimisation assessment
(BMJ Publishing Group Ltd, 2022-07-01) Ejalu David Livingstone; Mutyoba Joan N; Wandera Claude; Seremba Emmanuel; Kambugu Andrew; Muganzi Alex; Beyagira Racheal; Amandua Jacinto; Mugagga Kaggwa; Easterbrook Philippa; Ocama Ponsiano
Hepatitis B and HIV care share health system challenges in the implementation of primary prevention, screening, early linkage to care, monitoring of therapeutic success and long-term medication adherence. Arua regional referral hospital (RRH) and Koboko district hospital (DH), the West Nile region of Uganda. A cross-sectional hospital-based cost minimisation study from the providers’ perspective considers financial costs to measure the amount of money spent on resources used in the stand-alone and integrated pathways. Clinic inputs and procurement invoices, budgetary documents, open market information and expert opinion. Data were extracted from 3121 files of HIV and hepatitis B virus (HBV) monoinfected patients from the two study sites. To estimate provider costs associated with running an integrated HBV and HIV clinical pathway for patients on lifelong treatment in low-resource setting in Uganda. Outcome measures The annual cost per patient was simulated based on the total amount of resources spent for all the expected number of patient visits to the facility for HBV or HIV care per year. Findings showed that Arua hospital had a higher cost per patient in both clinics than did Koboko Hospital. The cost per HBV patient was US$163.59 in Arua and US$145.76 in Koboko while the cost per HIV patient was US$176.52 in Arua and US$173.23 in Koboko. The integration resulted in a total saving of US$36.73 per patient per year in Arua RRH and US$17.5 in Koboko DH.nThe application of the integrated Pathway in HIV and HBV patient management could improve hospital cost efficiency compared with operating stand-alone clinics.
Integrating hepatitis B care and treatment with existing HIV services is possible: cost of integrated HIV and hepatitis B treatment in a low-resource setting: a cross-sectional hospital-based cost-minimisation assessment
(BMJ, 2022-07-01) Ejalu David Livingstone; Mutyoba Joan N; Wandera Claude; Seremba Emmanuel; Kambugu Andrew; Muganzi Alex; Beyagira Racheal; Amandua Jacinto; Mugagga Kaggwa; Easterbrook Philippa; Ocama Ponsiano
Hepatitis B and HIV care share health system challenges in the implementation of primary prevention, screening, early linkage to care, monitoring of therapeutic success and long-term medication adherence. Setting was Arua regional referral hospital (RRH) and Koboko district hospital (DH), the West Nile region of Uganda. The research design used was a cross-sectional hospital-based cost minimisation study from the providers’ perspective considers financial costs to measure the amount of money spent on resources used in the stand-alone and integrated pathways. Data sources were clinic inputs and procurement invoices, budgetary documents, open market information and expert opinion. Data were extracted from 3121 files of HIV and hepatitis B virus (HBV) monoinfected patients from the two study sites. The objective was to estimate provider costs associated with running an integrated HBV and HIV clinical pathway for patients on lifelong treatment in low-resource setting in Uganda. The outcome measures were the annual cost per patient was simulated based on the total amount of resources spent for all the expected number of patient visits to the facility for HBV or HIV care per year. Findings showed that Arua hospital had a higher cost per patient in both clinics than did Koboko Hospital. The cost per HBV patient was US$163.59 in Arua and US$145.76 in Koboko while the cost per HIV patient was US$176.52 in Arua and US$173.23 in Koboko. The integration resulted in a total saving of US$36.73 per patient per year in Arua RRH and US$17.5 in Koboko DH. In conclusion, the application of the integrated Pathway in HIV and HBV patient management could improve hospital cost efficiency compared with operating stand-alone clinics.
Uganda’s experience in Ebola virus disease outbreak preparedness, 2018–2019
(BMC, 2020) Aceng Ruth Jane; Ario Alex R.; Muruta Allan N.; Makumbi Issa; Nanyunja Miriam; Komakech Innocent; Bakainaga Andrew N.; Talisuna Ambrose O.; Mwesigye Collins; Mpairwe Allan M.; Tusiime Jayne B.; Lali William Z.; Katushabe Edson; Ocom Felix; Mugagga Kaggwa; Bongomin Bodo; Kasule Hafisa; Mwoga Joseph N.; Sensasi Benjamin; Mwebembezi Edmund; Katureebe Charles; Sentumbwe Olive; Nalwadda Rita; Mbaka Paul; Fatunmbi Bayo S.; Nakiire Lydia; Lamorde Mohammed; Walwema Richard; Kambugu Andrew; Nanyondo Judith; Okware Solome; Ahabwe Peter B.; Nabukenya Immaculate; Kayiwa Joshua; Wetaka Milton M.; Kyazze Simon; Kwesiga Benon; Kadobera Daniel; Bulage Lilian; Nanziri Carol; Monje Fred; Aliddeki Dativa M.; Ntono Vivian; Gonahasa Doreen; Nabatanzi Sandra; Nsereko Godfrey; Nakinsige Anne; Mabumba Eldard; Lubwama Bernard; Sekamatte Musa; Kibuule Michael; Muwanguzi David; Amone Jackson; Upenytho George D.; Driwale Alfred; Seru Morries; Sebisubi Fred; Akello Harriet; Kabanda Richard; Mutengeki David K.; Bakyaita Tabley; Serwanjja Vivian N.; Okwi Richard; Okiria Jude; Ainebyoona Emmanuel; Opar Bernard T.; Mimbe Derrick; Kyabaggu Denis; Ayebazibwe Chrisostom; Sentumbwe Juliet; Mwanja Moses; Ndumu Deo B.; Bwogi Josephine; Balinandi Stephen; Nyakarahuka Luke; Tumusiime Alex; Kyondo Jackson; Mulei Sophia; Lutwama Julius; Kaleebu Pontiano; Kagirita Atek; Nabadda Susan; Oumo Peter; Lukwago Robinah; Kasozi Julius; Masylukov Oleh; Kyobe Henry Bosa; Berdaga Viorica; Lwanga Miriam; Opio Joe C.; Matseketse David; Eyul James; Oteba Martin O.; Bukirwa Hasifa; Bulya Nulu; Masiira Ben; Kihembo Christine; Ohuabunwo Chima; Antara Simon N.; Owembabazi Wilberforce; Okot Paul B.; Okwera Josephine; Amoros Isabelle; Kajja Victoria; Mukunda Basnet S.; Sorela Isabel; Adams Gregory; Shoemaker Trevor; Klena John D.; Taboy Celine H.; Ward Sarah E.; Merrill Rebecca D.; Carter Rosalind J.; Harris Julie R.; Banage Flora; Nsibambi Thomas; Ojwang Joseph; Kasule Juliet N.; Stowell Dan F.; Brown Vance R.; Zhu Bao-Ping; Homsy Jaco; Nelson Lisa J.; Tusiime Patrick K.; Olaro Charles; Mwebesa Henry G.; Woldemariam Yonas Tegegn
Since the declaration of the 10th Ebola Virus Disease (EVD) outbreak in DRC on 1st Aug 2018, several neighboring countries have been developing and implementing preparedness efforts to prevent EVD cross-border transmission to enable timely detection, investigation, and response in the event of a confirmed EVD outbreak in the country. We describe Uganda’s experience in EVD preparedness. : On 4 August 2018, the Uganda Ministry of Health (MoH) activated the Public Health Emergency Operations Centre (PHEOC) and the National Task Force (NTF) for public health emergencies to plan, guide, and coordinate EVD preparedness in the country. The NTF selected an Incident Management Team (IMT), constituting a National Rapid Response Team (NRRT) that supported activation of the District Task Forces (DTFs) and District Rapid Response Teams (DRRTs) that jointly assessed levels of preparedness in 30 designated high-risk districts representing category 1 (20 districts) and category 2 (10 districts). The MoH, with technical guidance from the World Health Organisation (WHO), led EVD preparedness activities and worked together with other ministries and partner organisations to enhance community-based surveillance systems, develop and disseminate risk communication messages, engage communities, reinforce EVD screening and infection prevention measures at Points of Entry (PoEs) and in high-risk health facilities, construct and equip EVD isolation and treatment units, and establish coordination and procurement mechanisms. As of 31 May 2019, there was no confirmed case of EVD as Uganda has continued to make significant and verifiable progress in EVD preparedness. There is a need to sustain these efforts, not only in EVD preparedness but also across the entire spectrum of a multi-hazard framework. These efforts strengthen country capacity and compel the country to avail resources for preparedness and management of incidents at the source while effectively cutting costs of using a “fire-fighting” approach during public health emergencies.