Bachelors Business Administration - Health Management

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Factors Affecting Male Involvement in the Prevention of Mother to Child Transmission of HIV :
(International Health Sciences University, 2012-09) Nanteza, Olivia Justine
Background: Over 95% of all pediatric HIV infections worldwide are accounted for by the Mother-To-Child Transmission (MTCT) of HIV. (MoH, 2009) Numerous studies have shown that male participation in the antenatal care of their spouses together with couple counseling and testing for HIV, increases use of the interventions for HIV prevention. The Prevention of Mother-To-Child Transmission of HIV program was launched in Uganda in 2000. Main objective: To establish the factors that affect male involvement in the PMTCT program in Makindye Division, Kampala district. Methodology: The study used a cross-sectional survey design. The sample size was 403 men who had ever had pregnant spouses in Makindye and they were chosen using the cluster sampling technique. Data was collected using semi structured questionnaires. Both descriptive and analytic statistics were used to analyse the data and it was reported in line with the objectives of the study. Results: The proportion of males who were involved in the PMTCT program was 35.7% (144/403). The men who attained secondary (OR=0.19, CI=0.06-0.59, P=0.004) and primary (OR= 0.21, CI=0.06-0.72, P=0.013) levels of education, those that had knowledge (OR=25.5, CI=7.71-84.62, P˂0.001) of Mother-To-Child Transmission of HIV, men who resided within 5 kilometers or less (OR=8.7, CI=1.40-53.61, P=0.020) from the health center, men who did not know about the availability of the PMTCT services (OR=23.8, CI=3.81-34.78, P˂0.001), availability of privacy at the health centers (OR=81.3, CI=11.77-562.02, P˂0.001) and those that did not know about the attitudes of the health workers to their clients (OR=618.6, CI=35.75-10704.39, P˂0.001) were significantly associated with male involvement in the PMTCT program. Conclusion: Men who resided within 5 kilometers or less from the health center, those that had knowledge of Mother-To-Child Transmission of HIV, a good attitude towards male involvement in the PMTCT program, and those that experienced short waiting times at the health centers were more likely to get involved in the PMTCT program. In addition, men who did not know the attitudes of the health workers towards their clients, availability of PMTCT program and availability of privacy at the health facility were also more likely to get involved than those who had an idea. On the other hand, men with primary and secondary level of education were more likely to be involved in the PMTCT program than those with no formal education. Recommendation The study recommends that the Ministry of Health and other stake holders should boost the health workers attitudes through improving their salaries, working conditions and bonuses. They should also create awareness of the PMTCT services through aggressive advertising and sensitizing the population through radio talks and other forms of media. This should be able to scale up uptake of the program services.
The Role of Employee Responsiveness on Customer Retention in Health Insurance Companies in Uganda :
(International Health Sciences University, 2012-09) Scovia, Galenda
The concept of employee responsiveness yields customer loyalty, which in the long run results into consistent customer retention. In this regard, this research report looks at how the excellent response from employees at International Air Ambulance, a health Management Organization will either affect business or improve it in as far as customer retention is concerned. The objectives of the study include: to identify the forms of responsiveness to customer needs; to ascertain the level of employee responsiveness to the customers’ needs; and to determine the link between employee responsiveness and customer retention. The researcher’s methodology incorporates an analytical cross-sectional study design. The study area used includes all International Medical Centers in Kampala District. The sample size was 80 respondents purposively used to obtain the up-to-date data for analysis. The data obtained with the use of questionnaire and interviews was analyzed using both Univariate and Bivariate analyses. The findings from the research indicate that positive employee response to organization policies as shown in Table 6 increases the ability of the organization to retain its customers. It is found that the swiftness with which an employee reacts to client issues increases the chances to retaining customers 67 (83.75%) while only 13 (16.25%) suggested otherwise. The respondents stated that positive employee response to organisation policies like, upholding customer confidentiality 14 (70.8%, r=0.69); handling clients’ needs appropriately 24 (85%, r=0.70) and staff being time conscious 31 (93%, r=0.81). In addition, respondents commented that other factors like, affordability 11 (86.7%), good services 30 (86.7%, r=0.71), variety of services 20 (82.6%, r=0.61), and location 8 (85.5% r=0.67), also influence the level of customer retention. The probability of employees continuing to use IAA services is highest if employees respond to client need fast by 31(93.0) and if they also respond to client needs positively by 24(85.0%). Conclusively, the elements of employee responsiveness lead to customer loyalty and in the long run are said to have fundamental implications towards consistent customer retention. The researcher argues that in order to be effective in retaining customers, a complete understanding of the aspects of employee responsiveness should be emphasized. The researcher therefore recommends; the need to increase & continue observing the swiftness with which clients’ needs are to be attended to; employees are to be encouraged to follow and respond to policies that favor clients and lastly availability of good and a variety of services should be put into consideration so as to create an attractive and enticing environment that supports customer retention.
Fraud and Service Delivery in Uganda's Health Sector :
(International Health Sciences University, 2012-09) Tumusiime, Alex
This research was carried out at selected Health centres in Wakiso District. The researcher examined “Fraud and its implications on Service delivery in Uganda’s Health Sector.” The objective of the research was to establish challenges faced during fraud management and its implications on health sector in wakiso district. Methodology: A cross sectional study was done while using random sampling and purposive sampling for patients and key informants corresponding. The tools used were research administered questionnaires and key informant interviews. Data that was collected was edited, entered into excel software and then analyzed using SPSS. Results: The actual causes of fraud were found to be inadequate drugs and lack of close supervision, i.e. (CI=0.27-28.39, OR=2.77, p-valve=0.001) and (CI=0.2-16.23, OR=1.38, p-valve=0.032) correspondingly. The challenges that are found to have a strong relationship with fraud were; political interference and (CI=0.05-4.58, OR=0.5, p-valve=0.040) and lack of professionalism (CI=0.04-1.70, OR=0.27, p-valve=0.002). However, the government has faced a number of challenges in managing fraud. Some of the challenge included the following among others, lack of transparence in implementation of policies in health sector, inadequate funds, political interference, lack of enough sensitization to workers and the public and inadequate skills. The research has also found the government has put on some measures which have been used to manage fraud. These include, increasing staff salaries, sensitizing the health workers and the public about the dangers of fraud and employing health workers who have enough skills in provision of health services. Recommendations: The study recommends that the corrupt officials should be punished through termination of contracts, imprisonment and returning what have been stolen in order to discourage those who would intend to commit fraud; Strong systems should be put in place to monitor and manage fraud within the health sector, health workers should be trained to behave professionally and deliver services to the expectations of the health sector and the general public; The government should increase the remunerations of health workers such that they cannot be tempted to commit fraudulent acts, and there should be transparency in implementation of activities to enable the public also to monitor and participate.
The Contribution of Customer Care to Patient - Satisfaction :
(International Health Sciences University, 2012-09) Mugema, Maximillian
The study entitled: “the contribution of customer care to patient-satisfaction” was conducted at the International Hospital Kampala. The overall objective was to establish the contribution of customer care to patient-satisfaction. The study specifically set out: to determine the level of customer care, to identify the level of patient satisfaction, find out the link between the customer care and patient satisfaction and identify other determinants that influence patient satisfaction at International Hospital Kampala. By design, the case study was both quantitative and qualitative. Primary and secondary sources were used to collect data. The secondary source involved reviewing relevant already existing literature about customer care and patient satisfaction. Primary data was obtained from 201 respondents randomly chosen from the out-patient department of IHK. Questionnaires and key informant interviews were the main data collection tools. The study was a success. The findings of the study were that there is a low level of customer care exhibited at IHK, patient satisfaction is generally low. Most of the respondents who had been clients for more than 2 years were mostly frustrated with the long waiting they are subjected to at IHK. The study found a strong positive link between customer care and patient satisfaction. It was safe to conclude that customer care in hospitals may not necessarily influence the satisfaction of patients evidenced by the fact that customer care at IHK was of low standards than should have been ideally and that the patients had other considerations from which satisfaction was derived. The study recommends training the health workers so as to improve on the knowledge, attitude and practices that involve customer care, and that International Hospital Kampala should recruit more health-workers in order to combat the long waiting queues at hospital as noted in the study; motivate the staff members so that they can bridge the link between customer care and patient satisfaction; maintaining the goodwill that the hospital already has since it has been more satisfying than the care according to the study. Areas of further study derived from this study; the link between staff satisfaction and customer satisfaction in regards to customer care. The study results are not conclusive about the causes of dissatisfaction with outpatient services because the researcher did not have a comparison group.
Identification of Occupational Safety and Health Hazards and their Causes Among Health Care Workers of Mengo Hospital, Lubaga Division, Kampala District.
(International Health Sciences University, 2013-09) Githingi, Florence Wamuyu
There are numerous occupational hazards that prevail in many hospitals in Sub-Saharan Africa and Uganda. This study therefore sought to determine the factors influencing identification of occupational safety and health hazards and their causes health care workers of Mengo hospital. The objectives of the study were identifying occupational hazards among health workers in Mengo hospital, individual factors influencing identification of occupational safety and health hazards and their causes health care workers of Mengo hospital and health system factors influencing identification of occupational safety and health hazards and their causes health care workers of Mengo hospital. A hospital based cross sectional study was carried out, enrolling a total of 105 health workers in Mengo Hospital. Data was collected which included socioeconomic characteristics, individual factors and health system factors with the use of a researcher administered questionnaire. On encountering occupational hazards, all the respondents 105 (100%) had experienced them while at work in the hospital. The Chi-square statistical test was employed using Statistical Package for Social Scientists (SPSS) program and variables such as interpersonal conflict, exposure to work related violence or threats, sleep deprivation, training on safety in the hospital , resources put in place by the hospital management to promote occupational safety and health , imposing of hospital management system by senior management without consultation , management systems customized to the organizational needs and occupational safety marginalized by hospital management system showed a statistically significant association with encounter of occupational hazards (p<0.05). Variables such as rate of relationship between the health workers and the hospital management showed no statistical association on encounter with occupational hazards in this study. In this study, all the respondents 105 (100%) had experienced some form of occupational hazard while at work in the hospital. However, those which were specifically more experienced by the health workers included infectious disease, (53.3%), needle pricks (64.8%), working beyond a stipulated shift, repetitive strain injuries and conflicts. The results in this study showed that occupational health hazards were prevalent among the health workers in Mengo hospital with the most prevalent being needle stick injuries, interpersonal conflicts, repetitive strain injuries, working beyond stipulated shifts, sleep deprivation, and interpersonal conflicts. The researcher’s recommendations are as follows: The hospital management should do a barrier analysis where communication plays a vital role in risk analysis to ensure that risk management strategies effectively minimize occupational hazards among health workers, training on hazards and emergency response; The health workers should adapt safety culture and adhere to universal precaution practices; The academia should conduct further studies in hospitals to establish if the health workers do adhere to health and safety measures put in place.
Factors Influencing the Up-Take of HIV Post Exposure Prophylaxis (PEP) Services Among Nurses in Sumbawanga Municipality - Tanzania.
(International Health Sciences University, 2013-09) Stella, Yengi
Introduction: Human Immune deficiency virus/AIDS is posing a problem to the world especially in Sub-Saharan Africa including Tanzania. The WHO, UNAIDS and other International Organisations are making effort to increase the availability of antiretroviral drugs (ARV’s) to infected persons including HIV PEP drugs for non occupational and occupational exposure. Since its initiation in Sumbawanga Region in Tanzania in 2007, only 42 health workers had reported and initiated HIV PEP following occupational exposure. Objective: To investigate the prevalence, knowledge, health facility factors and attitudes towards HIV PEP uptake services in occupational exposure among nurses in selected facilities/hospitals at Sumbawanga Municipal Tanzania. Methods: A cross-sectional study was carried out where 196 of nurses who work in the Region, district hospitals and health facilities were purposively selected. A number of structured questionnaires were administered to the study participants where information regarding various factors (social demographic, prevalence, knowledge, health facility and attitudes ) leading into low HIV PEP up take, was collected and analyzed. Results: The results revealed that uptake of HIV PEP services among the nurses was still low 24.2% despite a majority of (77%) respondents who had heard about HIV PEP. It was also found that, the majority, who heard about PEP had low level of knowledge about the meaning of PEP and Occupational Exposure. Results have also shown that there was High Negative Attitude ( 54% ) towards HIV PEP among the participants. Conclusion: Knowledge about HIV PEP and Occupational Exposure is still very low which is indicated by low prevalence of those who take PEP, and who define PEP and Occupational Exposure. Also negative attitudes towards HIV PEP, contributes to low uptake of HIV PEP services. It is recommended that knowledge should be raised through, weekly job training, (on job training), sharing of information between staff.
Factors Influencing the Utilization of STI Services among the Youth Aged 15- 24 Years in Nabweru Sub-County-Wakiso District.
(International Health Sciences University., 2014-11) Sempijja, Yasin
Introduction: Sexually transmitted infections are posing a problem to the world especially in Sub-Saharan Africa including Uganda. The WHO, UNAIDS and other International Organizations are making effort to increase the availability of STI services to the infected persons including VTC and STI treatment drugs. Objective: To investigate the proportion, knowledge, attitude and health facility factors towards the utilization of STI services among the youth aged 15-24yrs in Nabweru sub-county Wakiso district. Methods: A cross-sectional study was carried out where 224 youth who lived in Nabweru sub-county were selected using a combination of cluster, simple random and convenience sampling. A number of structured questionnaires were administered to study participants where information regarding various factors (social demographic, proportion, knowledge, attitude and health facility) leading to low STI services utilization, was collected and analyzed. Results: The results revealed that utilization of STI services among the youth aged 15-24yrs was still low 15% despite a majority of respondents 137 (61.2%) who knew where they could access the STI services. It was also found that, the youth who had heard about STIs, (59%) had low level of knowledge. Results also showed that there was Neutral Attitude (54%) towards the utilization of STIs services among the participants. Conclusion: Knowledge about STI services is still very low which is indicated by low proportion of those who utilize the services. Also neutral attitudes towards the utilization of STI services, contributes to low uptake of STI services. It is recommended that knowledge should be raised through, sensitization of the youth about STI services.
The Influence of Leadership Styles on Job Satisfaction :
(International Health Sciences University., 2014-11) Tugumenawe, Anata
Analysis of Organizational Culture in Health Center threes :
(International Health Sciences University., 2014-11) Nakiyinji, Mable
Factors Influencing Team Work Among Health Workers:
(International Health Sciences University., 2014-11) Oyet, David
Background: Team work is where two or more people come and work together with a shared purpose of achieving a common goal. Team work among health workers is critical for effective implementation of disease control interventions. Activities such as laboratory testing, diagnosis, counseling, and prescription of medicines, health education and maintenance all require different personnel with specific skills. Failure to enforce an effective team in health care, Healthcare service delivery will continue to decline. Methodology: In this health center, a cross sectional study composed of 36 respondents was done. The respondents composed of both medical and support staff. We used both convenient and quota sampling techniques. Under convenience sampling, the researcher only considered the respondent who was accessible at the time of the study when a specific health facility was visited. Data collection was done using standard questionnaires to health workers and support staff. Pre-testing of the tools was done before the actual data collection started and analysis was performed using SPSS version 16. Main findings: 1. Social- economic factors influencing team work. Social-economic factors such as age (p=0.003) and level of education (p=0.004*) were found to have a statistically significant association (p<0.05) with working as a team among the health workers. Other social-economic factors such as age, marital status, religion and the average monthly income did not show a statistically significant association (p>0.05) with working as a team among the health workers. 4.4.2 The individual factors influencing teamwork among health workers. 2. Proportion of health workers involved in teamwork. Majority of the respondent, 31 (86%) reported to be involved in team work by working as a team in the course of their duties while 5 (14%) reported not to do so. 3. Knowledge of health workers on team work. Majority of the respondents, 34 (94.4%) had adequate knowledge on team while only 2 (5.6%) had average knowledge. 4. Organizational factors influencing team work among health workers Organizational factors such as duration of work that a given health worker has worked at the health facility (p=0.006*), the work load at the health facility (p=0.002*), the remuneration scale (p=0.012) and the motivation of health workers to practice team work at the health facility (p=0.007) were found to have a statistically significant association with team work among the health workers. Other organizational factors such as existence of human resource policies on team work, supervisors encouraging team work, motivation of staff, level of coordination, level of communication and decision making approach at the health facility did not show a statistically significant association (p>0.05) with team work among health workers.
Factors that Influence Motivation of Employees in Private not for Profit Health Facilities in Kabale District.
(International Health Sciences University., 2014-11) Agaba, Andrew
Assessment of Pharmaceutical Supplies Management by Public Health Facilities:
(International Health Sciences University., 2014-11) Tapi Ogom Dorothy, Ogom Dorothy
Background: Pharmaceuticals which are commonly known as ― “medicines”, are chemicals which have been specifically engineered to influence physiological systems whether in man, animal, or microbes. Pharmaceutical management represents the whole set of activities aimed at ensuring the timely availability and appropriate use of safe, effective quality medicines and related products and services in any health care setting. Even though there progressive success in the pharmaceutical supplies in the public health facilities in Uganda, there has been evidence of poor pharmaceutical management among health workers, including irrational use of medicines, high number of medicines per prescription, high number of medicines in stock and poor disposal methodology. Objectives: The purpose of the study was to establish the management of pharmaceutical supplies in public health facilities, a case of Bombo military referral hospital which entails the following objectives; Acquisition procedures of pharmaceuticals to health facilities, Pharmaceutical storage methods and conditions, Pharmaceutical dispensing practices, Client knowledge about pharmaceutical usage. Methodology: This was a descriptive cross-sectional study involving both qualitative and quantitative approaches. The study population constitutes all health departments directly involved in the management of pharmaceuticals in Bombo military referral hospital. Stratified sampling was used to determine the proportion of the respondents to be sampled for each category that is the health workers. There were four strata in total consisting of procurement, store management, prescribing personnel and patients. Simple random sampling was used to sample the respondents in their respective strata. The study used both quantitative and qualitative techniques in data collection. Data was collected through self administered questionnaire from the health workers. Results: Sixty three point six percent (14) of the respondents admitted there are no devices used to monitor conditions, such as temperature, during transportation of pharmaceuticals to the facility. 90.9% (20) of the study participants agreed the dispatch and transportation of pharmaceutical products is carried out only after receipt of a delivery order. Furthermore on transportation, 86.4% (19) of the respondents admitted there are dispatch procedures established and documented, taking into account the nature of the materials and pharmaceutical products concerned and any special precautions taken. Seventy five percent of the respondents admitted the store is separate from the dispensary with 62.5% (5) of the study participants admitting medicines are dispensed to users only from the dispensing area. However, on the size of the store, half of the respondents 4 (50.0%) disagreed that it was large enough to keep all supplies. On the other side, 62.5% of the respondents admitted the supplies are systematically classified on the shelves (i.e., by dosage forms or therapeutic class). However, 75.0% of the respondents were against the statement that supplies are arranged on the shelves in alphabetical order by generic name within each category. All the respondents admitted they always ensure the prescriptions are correct as well as dispensing using envelopes and small bottles with label having patient, medicine, and quantity details. On dosage, each and every respondent admitted checking the dose when placing the medication into the packaging container. On the other side however, 47.1% (8) of the respondents admitted it‘s not a routine for them to check the route of the drug administration at least three times before giving the medication. Responses sought on respondents‘ knowledge on pharmaceutical labelling revealed 91.0% of the respondents were against the presence of patient name on the label as shown in table 7 below. The words ̳keep out of reach to children‘ were not news to 72.8% of the respondents well as 65.9% of the respondents to them words such as Not to be Taken‘ or For external Use Only‘ were not news to them on external medicines. Conclusion: Pharmaceutical management at Bombo hospital is fairly done, relative to the management of essential management policies as set out by the ministry of health. The well handled pharmaceutical management policies were the acquisition procedure, and dispensing practices. The area which needed attention was the storage of the medicines as this was found to having many gaps. Recommendations: It is recommended that training for NDA staff and relevant staff from the local pharmaceutical manufacturers is done, computerization of the drug management information system, is implemented to create an easy to use data base for policy/programme and medicine control activities, as well as provide relevant data for manufacturers.
Knowledge, Attitude, Motivation and Beliefs Towards Donating Blood Among Youths in Kampala, Uganda:
(International Health Sciences University., 2014-11) Mukiibi, Sperito
Factors Influencing the Availability of Medicines in Government Health Facilities in Uganda:
(International Health Sciences University., 2014-11) Kaprunge, Dominic
This study aimed at finding out the factors influencing the availability of medicines in Government health units in Bukwo district a case of Bukwo hospital, and suggest measures to improve availability of medicines in Bukwo hospital ,The study used quantitative and qualitative design and the independent variable such as availability of medicines and influencing factors such as management capacities, communication, storage, transportation, ordering for medicines, delivery of medicines, inadequate funding and theft of medicines were quantitatively measured while variables such as sex ,education levels and management capacities were qualitatively measured. The study was done in Bukwo hospital with a target population of health workers and constituted a sample size of 90 respondents obtained by simple random sampling, primary data was obtained from the respondents using questionnaires administered to the respondents and the results were analyzed using S.P.S.S. The results revealed that delay of health workers to order for medicines greatly influenced the availability of medicines negatively in Bukwo hospital, it was also found out that funding for medicines was not contributing to non availability of medicines in Bukwo hospital and that theft of medicines was not significantly contributing to non availability of medicines in Bukwo hospital while the management system was not contributing to the none availability of medicines of in Bukwo hospital and also the stores personnel are adequately trained to manage the stores while on the low remuneration to health workers the study found out that low remuneration tempt health workers to steal medicines in order to sell and supplement on their low incomes, on prescription quality the study found out that poor prescription quality does not significantly influences the availability of medicines in Bukwo hospital yet on Dispensing quality the study found out that poor dispensing quality influences availability of medicines in Bukwo hospital and further still on reporting quality and timeliness the study found out that a far greater percentage 64(70%) of the respondents agreed that reporting quality and timeliness influenced the availability of medicines in Bukwo hospital. In conclusion therefore several factors such as delay in ordering, delay in delivery,communication, lack of a store, low remuneration, and reporting quality and timeliness all compound to cause inadequate stock levels of medicines in Bukwo hospital which therefore callsfor policy changes and capacity building on staff to improve on the areas of concern.
Staff Motivation and its Effect on Job Satisfaction in Uganda’s Military Hospitals:
(International Health Sciences University., 2014-11) Kintu, Edmund
This research addressed the importance of the human resource for health in the military perspective and the effect of the different motivation factors on the level of job satisfaction of Bombo military hospital staff with the aim of improving the overall delivery of health care services. Objective: The objective of the study was to identify staff motivation factors and their effect on job satisfaction at Bombo Military Hospital. Methods: this study used a descriptive cross sectional survey design that involved 200 respondents (health workers) and hospital administrators in the age group of 20 – 50 years of age working at Bombo Military Hospital, Uganda, Luweero District. The sample size was determined by using normal approximation to the hyper geometric distribution formula for small populations (Evan morris 2014) at a margin error of 0.03. Results: Motivation among the staff of Bombo Military Hospital in Uganda is still low which results in the increased level of job dissatisfaction. Majority of the respondents were male 117 (58.5%) than female 83(41.51%) and male were less satisfied with their jobs than the females. The result on the age of respondents revealed that the majority 115(57.5%) of 20-30 years, followed by 31-40 years 54(27.0%). The least number of respondents were of 41-50 years and those above 50 years with 18(9.0%) and 13(6.5%) respectively. There was statistically significant association between sex/age of respondents and job satisfaction. There was statistically significant relationship between profession category and job satisfaction (χ 2 =70.11 df =3 P-value =0.001) and there was no statistically significant relationship between frequency of military promotions and job satisfaction. There was statistically significant relationship between years staff worked at Bombo military hospital and job satisfaction (χ 2 =6.86 df =2, P-value =0.032). On the other hand, it emerged that out of 65(32.5%) nurses, none of them agreed to be satisfied with their job. Knowledge and perception of Bombo Military Hospital staff on motivation factors had a significant influence on staff‟s job satisfaction levels. Recommendation: The study revealed that majority of the staff at the hospital were not satisfied with their jobs therefore recommended the following factors; clear job description on the time of recruitment should be appliedto all military employees. Military should sponsor more health workers for further studies, Separate military chain of command from health care chain of command, Retirement entitlement for all. All administrators should be educated in the field of management and not automatically made administrators due to their military ranks, all medical staff should get the respect they deserve and not discriminated by military rank or professional category, Annual leaves should be respected. Military should provide more accommodation facilities and transport to it staff, Uganda government should provide more financial funding to BMH, and the hospital administration should introduce public service policy of annual appraisals to all its employees including the health workers. Further research should done so as to identify the effects of military system to health care service delivery since the leadership style in the military hospitals is more autocratic than then in the civilian managed hospitals.
Assessment of Patients' Perceptions on Quality of Healthcare Services in Selected Health Center IV's in Mityana District.
(International Health Sciences University., 2014-11) Ninsiima, Loyce
Assessment of health Management Information System in Juba County, Central Equatoria State, South Sudan.
(International Health Sciences University., 2015-12) Kiden, Rosemary; Joshua
Background; Health information system is the process collecting, analyzing, processing reporting and using the information got for policy making and conducting research. Health Information Systems tackles areas such as socio-economic, environmental, behavioral and genetic factors. Inputs such as human resource, equipment, health infrastructure and cost are also included to the health information system. Problem statement; In south Sudan, the lack of reliable health information has led to an unsuccessful planning and implementation of the health service delivery in the country. HMIS objectives are to use the data collected from the health facilities for monitoring and evaluation of activities which are then be forwarded to the state ministry of health for compilation and implementation of activities. Yet this is system is still lacking in South Sudan. Objective; The general aim of the study was to review the strength and weakness of the health management information system (HMIS) in Juba County, South Sudan with a view of coming up with recommendations given the results. Methods; A descriptive cross sectional design was used for the study. The data was gathered using Quantitative and qualitative methods. The study population included the county Health Department (CHD) officers, health managers and staffs who are concerned with the collection, analysis utilization and dissemination of health information. Juba County was purposely sampled based on the existence of a functioning HMIS and because most of the administrative works were done there. Simple random sampling technique was used to select the facilities. Face to face interviews, key informant interviews, and document reviews were used to collect the data. Structured questionnaire, Key informant interviews were used for collecting the initial data. Results; Health Management Information System in Juba County was only 39% efficient. About 7.1% (33) of the respondents admitted there is county board put in charge of HIS coordination in their respective facilities. On availability of HMIS manuscripts, fifty four point percent of the respondents denied its availability, 42.4% (14) of the respondents acknowledged the availability of computers, 40.0% (28) of the respondents agreed a county recording system for public and private health units with sole identifying numbers is in place. Fifty six point seven percent (17) of the respondents admitted they fully make use of censuses in Juba County and the nation in their HMIS. Half of the respondents 15 (50.0%) agreed they fully utilize civil registration in Juba County although the other half disagreed with it. On fully utilizing population surveys in the county, 43.3% (13) of the respondents agreed with it. About 46.7 (14) of the respondents fully utilized individuals records of people in Juba county in their HMIS although on service records, only 9 (30.0%) admitted not fully utilizing them. The factors that had salient influences on the efficiency of the HMIS in Juba County were the number of years the respondent had worked at a particular facility (p=0.007), existence of an official policy to carry out regular meetings at health care units and health managers, to review the HIS (p=0.013), existence of a county recording system of public and private health units with unique identifying figures (p = 0.035), performance of data analysis by health facility (p=0.038). Conclusion; Generally the results show that the HMIS in Juba County has a low HMIS efficiency given its outputs (39%), implying that the ministry of health has to make more interventions to improve on this efficiency. Recommendations; County offices should support the health facilities with stationery. Provide counter books, monthly summary tally sheet form for data collection. The county offices should set up record/resource centers at all health units. Ministry of Health should also provide more computers and other sophisticated information technology equipment at the county level and train personnel for data processing.
Factors Influencing Utilization o Dental Services Among Pregnant women in Referral Hospital of Bunia, in Democratic Republic o the Congo.
(International Health Sciences University., 2015-12) Tibasaga, Lossi; Rogelyne
Background: Poor oral health during pregnancy is progressively connected to adverse pregnancy outcomes, as well as preterm low-birth weight infants and morbidity and mortality in sub- Saharan Africa and world wide. In DRC there is no study done to determine the factors influencing dental services utilization among pregnant women. This study assess factors influencing dental services utilization among pregnant women in Bunia referral hospital, in Democratic Republic of the Congo. Objective: The overall objective of this study was to assess the factors influencing utilization of dental services among pregnant women in Bunia referral hospital in Democratic Republic of the Congo. Methodology: A cross-sectional descriptive design and a semi-structured questionnaire were used to collect data from 384 women attending antenatal care in Bunia referral hospital. Chi-square/Fisher’s exact test and binary logistics regression analysis were used to examine factors associated with utilization of dental services among pregnant women. Results: Majority of respondent were young(18 to 27 years). Only 12.12 % reported having visited a dentist of which 88.2% utilized extraction services. The only significant factors associated with low utilization of dental services were the unplayable oral services were not appreciated by mothers because the services were not for their advantage. The awareness of the dental services in Bunia referral hospital (OR, 9.761, 95% CI: 1.495-5.796, P=0.002) and the cost of dental services (OR, 9.406, 95% CI: 1.610-8.698, P= 0.002). And Cultural value that influence dental services was cultural belief (8.130, 95% CI: 1.295-4.030, P= 0.004). Conclusion: The level of utilization of dental services among pregnant women in Bunia referral hospital is remarkably low. Although pregnant mothers were aware of the availability of dental services, the cost of the services was not affordable for the majority of mothers and cultural belief that dental services in pregnancy could have a negative effect on pregnancy outcomes were associated with utilization of the services among pregnant women in Bunia referral hospital. Recommendation: Intervention toward outreach dental health services to conducting community health education within the district to emphases the importance of dental health services and continuous education to mothers to change attitude toward cultural belief may play a vital role in enhancing the utilization of dental services among pregnant women in Bunia referral hospital.
Factors Influencing Utilization of Antenatal Care Services in Health Centres (III) in Gulu district.
(International Health Sciences University., 2015-12) Ahmed, Abdi; Botan
Introduction: The health status of pregnant women majorly depends on the quality of antenatal care services utilized by them. It is against this background that this study attempted to determine the factors influencing the utilization of antenatal care services in health centres III in Gulu District. Methodology: A cross-sectional study employing both qualitative and quantitative methods was carried out. Questionnaires and face to face interviews were used as tools to collect data in the health centres III in Gulu district. Data was obtained from the ANC attendees. Results: This study revealed that 92.3% of the pregnant women utilized antenatal care services in health centres III in Gulu district. 96.2% of the women pregnancies were intended and all the women who respond appreciated the importance of ANC. The following factors showed significant influence on the utilization of ANC; Age (X2= 14.720, P= 0.000), Religion (X2= 13.650, P= 0.002), Marital status (X2= 20.687, P= 0.000), educational status (X= 21.658, P= 0.000), Occupation (X2= 18.745, P= 0.045) and Residence (X2= 24.458, P= 0.012). Majority of the women did not attend ANC due to lack of transport (23.1%) and long distance to the health centres (21.2%). Conclusions and recommendations: Though the rate of utilization of antenatal care services in health centre III in Gulu district is high, it losses meaning if the majority of the mothers who attend ANC did not receive adequate number of visits and initiated the visits later than recommended by the World Health Organization. In addition educational status, age, residence and occupation were major predictors of ANC service utilization. Therefore, I would suggest that more efforts should be put towards understanding these major predictors at community and individual level through behavioral change communication.
Assessment of community led total sanitation in achieving open defecation free status in Nwoya district, Uganda.
(International Health Sciences University., 2015-12) Bongomin, Bob; Junior
Introduction: CLTS is an innovative methodology for mobilizing communities to conduct their own appraisal and analysis of open defecation (OD), stimulating a collective sense of disgust and shame among community members as they confront the crude facts about mass OD and its negative impacts Objective: To assess Community Led Total Sanitation in achievement of Open Defecation Free Status in Nwoya district. Methods: The study used cross sectional study design that involved 358 respondents (household heads) in Nwoya district. The sample size was determined using Yamane‟s formula at 5% precision. Multi stage sampling method was used and data was collected by structured questionnaire, key informant interview guide and observation check list. It was entered in Excel entry sheet for cleaning and exported to IBM SPSS version 21 for statistical analysis at 95% confidence level. Chi-square test was used to analyze the relationship between the dependent and independent variables. Relationships with probability values less than 0.05 were deemed statistically significant for logistic regression analysis into odds ratios with 95% confidence intervals. Meanwhile, qualitative variables were analyzed via content analysis into themes. Results: 196(54.7%) of the respondents were females compared to males 162(45.3%. The mean age was 38.3 years with standard deviation of 12.34; 1 in 6 that is 17 % (60) out of 358 with 95%CI 13%-21%) respondents were from ODF and 83% from Non ODF villages. At bivariate analyses, occupation education level at socio-demographic were significant. CLTS triggering (uOR 3.8, 95%CI 0.11-0.867 P=0.01), follow up by CLTS facilitators (uOR=4.05 95%CI (2.22-7.38 P=0.001) and (uOR=1.97 95%CI 1.12-3.48 p=0.019) follow up by community leaders, community participation, training, involvement of children and women (uOR 2.30 95%CI 1.31-4.028 P=0.04) were statistically significant in ODF status achievement. At multivariate analysis, occupation, education CLTS triggering and follow up by facilitators had statistically significant variables associated to achievement of ODF in Nwoya district. Conclusion and Recommendations: Scale up triggering and follow ups, involve children and women, encourage full participation from every community member, ensure children both boys and girls go to school beyond secondary education, organize CLTS training for key community leaders and influential members.

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