Sustainability of quality improvement teams in selected regional referral hospitals in Tanzania

Abstract Objective The aim of this study was to determine the sustainability of hospital quality improvement teams and to assess factors influencing their sustainability in the regional referral hospital in Tanzania. Design A cross-sectional study was conducted between April and August of 2018. Setting and participants The study was conducted in four selected regional referral hospitals in Tanzania. All members of the quality improvement teams available during the study period were recruited. Intervention Quality improvement teams and their activities. Main outcome measure The primary outcome was sustainability total scores. The secondary outcomes were process, staff and organizational sustainability scores. The sustainability of quality improvement teams was assessed by using the National Health Service Institute for Innovation and Improvement Sustainability Model self-assessment tool. Results The overall mean sustainability score was 59.08 (95% CI: 53.69–64.46). Tanga Regional Referral Hospital had the highest mean sustainability score of 66.15 (95% CI: 55.12–77.18). Mbeya Regional Referral Hospital obtained the lowest mean sustainability score of 52.49 (95% CI: 42.96–62.01). The process domain had the highest proportionate mean sustainability score of 22.46 (95% CI: 20.58–24.33) across four hospitals. The staff domain recorded the lowest proportionate sustainability score of 27.28 (95% CI: 24.76–29.80). Conclusions Perceived less involvement of senior leadership (hospital management teams) and clinical leadership (heads of clinical departments) and infrastructure limitation appeared to negatively affect the sustainability of the hospital quality improvement teams. Our study underscores the importance of establishing a permanent and fully resourced Quality Improvement Unit—with team members employed as full-time staff.

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Early Malaria Diagnosis and Treatment Seeking Behavior Among Clients Attending Outpatient Department Sekou-Toure Regional Referral Hospital in Mwanza, Tanzania; A Cross-Sectional Study

10.20944/preprints202112.0387.v1 ◽

2021 ◽

Author(s):

Samson Mvandal ◽

Godfrida Marandu

Keyword(s):

Health Facility ◽

Early Treatment ◽

Malaria Diagnosis ◽

Cross Sectional Study ◽

Referral Hospital ◽

Treatment Seeking ◽

Sectional Study ◽

Cross Sectional ◽

Regional Referral Hospital ◽

Seeking Behavior

Early diagnosis of malaria and treatment seeking behavior play key role in controlling and preventing further complication related to malaria disease. Aim of this study was to determine the responses on early malaria diagnosis and treatment seeking behavior among outpatient clients attending at Sekou toure regional referral hospital in Mwanza, Tanzania. Methods: A cross-sectional study was conducted among outpatient client at Sekou-Touré regional referral hospital, convenient simple random sampling used and self-administered questionnaire were used to collect data and data was entered into Microsoft excel and then exported to SPSS version 25.0 for further analysis and presented on the percentages and table. The analysis of strength of relationships between categorical variables was conducted using the Chi-square test. A p-value of ≤ 0.05 was considered to be statistically significant. Results: A total of 192 respondents completed the study with a response rate of 97.6%. The study revealed that Most of the respondents about 90.6% stated they would seek treatment from health facility when symptoms appear. However, only 6.3% seek treatment within 24 hours of onset of illness (p= 0.017). Half of respondents (50.5%) experienced malaria symptoms in the past six months and only 30% seek for treatment at health facility. Preference of health facility, (51%) respondents were going direct to pharmacy to buy medicine for self-treatment. Overall, cost of service, time consumed and distance of health facility especially health center shows significant with such delay. Conclusion: A low proportion of malaria-suspected patients sought treatment within 24 h of fever onset compared to the national target. Distance from the health facility, cost of service and time consumed were found to be predictors of early treatment-seeking behavior for malaria. Strengthening strategies tailored to increasing awareness for communities about malaria, importance of going hospital and early treatment-seeking behavior is essential.

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Post Caesarean Wound sepsis and associated factors among patients attending a rural regional referral hospital in Western Uganda: A cross-sectional study

10.21203/rs.2.24374/v1 ◽

2020 ◽

Author(s):

Ismael Muhumuza ◽

Abdulrahman Zeinul Lavingia ◽

Bekson Tayebwa ◽

Ahmed Abdulhussein Ahmed ◽

Farhiya Mohammed Koriow ◽

...

Keyword(s):

Health Workers ◽

Bacterial Pathogens ◽

Cross Sectional Study ◽

Referral Hospital ◽

Vaginal Examination ◽

Sectional Study ◽

Wound Sepsis ◽

Cross Sectional ◽

Regional Referral Hospital ◽

Antibacterial Susceptibility

Abstract Background : Post-caesarean wound sepsis is among the most common problem for patients who undergo caesarean section. It remains a common and widespread problem contributing to morbidity and mortality; this could be due to an increase in antimicrobial resistance. Determining the burden of wound sepsis and common bacterial pathogens can provide solution to prevent incidence and establish microbiological mapping. Aim: To determine prevalence, identify factors, common bacterial pathogens from post-caesarean wounds and antibacterial susceptibility pattern at Hoima Regional Referral Hospital. Methods : A cross-sectional study was conducted among post-caesarean mothers attending Hoima Regional Referral Hospital. Consecutive enrolment of 303 participants who consented to participate was done. Structured questionnaires were used to collect data on associated factors and wound swabs were done prior to bacterial culture. Antibacterial susceptibility pattern of isolated bacterial pathogens was determined by Kirby Bauer disc diffusion method. Data was analyzed using Stata 14.2. Results : The wound sepsis rate was 16.8%. Being educated, multiple vaginal examination, hygiene, previous caesarean sections and HIV seropositivity were all significantly and positively associated with post-caesarean wound sepsis (p<0.05). The most implicated bacteria was Staphylococcus aureus and was most susceptible to ciprofloxacin. Resistance was most exhibited against ciprofloxacin, gentamycin, ceftriaxone and cotrimoxazole especially by coliforms. Conclusions. The rate of caesarean wound sepsis is high at Hoima Regional Referral Hospital . Being educated, multiple vaginal examination, hygiene, previous caesarean sections and HIV seropositivity are possible risk factors for the condition. Staphylococcus aureus is the commonest organism isolated from exudates of septic wounds after caesarean section. Awareness amongst health workers and patients about these major factors is necessary so that management can be directed. Rational use of antibiotics by health workers is paramount to combat resistance in this setting.

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Nutritional Knowledge and Practice among Patients with Non-communicable Diseases Attending Mbale Regional Referral Hospital in Eastern Uganda: A Cross Sectional Study

International Journal of TROPICAL DISEASE & Health ◽

10.9734/ijtdh/2019/v37i130154 ◽

2019 ◽

pp. 1-11

Author(s):

Esther Nambala ◽

Jayne Byakika-Tusiime ◽

Yahaya Gavamukulya

Keyword(s):

Cross Sectional Study ◽

Nutrition Knowledge ◽

Referral Hospital ◽

P Value ◽

Nutritional Knowledge ◽

Sectional Study ◽

Cross Sectional ◽

Regional Referral Hospital ◽

Adequate Knowledge ◽

Eastern Uganda

Aim: To determine nutritional knowledge and practices among patients with Non-Communicable Diseases (NCD) attending Mbale Regional Referral hospital, in Eastern Uganda. Study Design: A mixed methods cross sectional study design was used. Place and Duration of Study: Mbale Regional Referral Hospital among patients attending the NCD clinic from May to July 2017. Methodology: Two hundred sixty clients were recruited for the study. Quantitative data was collected through structured administered questionnaires. Quantitative data was analyzed at univariate, bivariate and multivariate levels. Chi square test and logistic regression were used to determine the association between nutrition knowledge and utilization. Qualitative data was coded first and summarized according to the themes. Results: The mean age of the respondents was 55 years (SD= 14) and hospital was the main source of nutrition information (n=156, 60%). Most respondents (n=156, 60%) had a high level of nutrition knowledge, however only 48.8% (n=127) were utilizing the knowledge. Those who had attained secondary level of education were 2.308 more likely to utilize the nutrition knowledge than those who had never studied P value of .028, 95CI (1.093-4.874). Those with tertiary education were even 9.261 times more likely to utilize the knowledge P value <.001 95CI (2.721-31.522). Those with adequate knowledge were about 1.6 times most likely to utilize the nutrition knowledge compared to those with inadequate knowledge level, however, with the adjusted odd ratio of 1.573 at 95% CI (0.923- 2.868) the results were not statistically significant (P value .098). Conclusion: NCD patients had adequate knowledge, with a few of them utilizing the knowledge. High education level was associated with better nutrition practices.

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Knowledge and Practices of Post Cesarean Section Mothers Towards Self-Care After Delivery at Mbarara Regional Referral Hospital.

10.51168/sjhrafrica.v2i3.23 ◽

2021 ◽

Author(s):

◽

Solomon Atuhaire

Keyword(s):

Cesarean Section ◽

Self Care ◽

Cross Sectional Study ◽

Study Data ◽

Referral Hospital ◽

Postpartum Woman ◽

Postpartum Women ◽

Microsoft Excel ◽

Cross Sectional ◽

Regional Referral Hospital

ABSTRACT Background: It is recommended to all mothers to undergo post-cesarean section self-care after delivery up to six weeks. However, many mothers return to Mbarara Regional Referral Hospital as a result of getting some complications related to cesarean section. The reasons why these mothers develop these complications are not clear and possible other practices performed by delivered mothers to solve their post-delivery challenges are not yet documented. Methods: The design of this study was a descriptive cross-sectional study design and a semi-structured questionnaire was used to collect quantitative data from the participants. Data were collected from 150 mothers admitted to the Maternity ward of Mbarara Regional Referral Hospital who formed the inclusion criteria and accepted to participate in the study. Data was captured using Microsoft excel and analyzed using Statistical Package for social sciences (SPSS). Results: The response rate in this study was 100%. The knowledge of post-cesarean section self-care among postpartum women at MRRH in Mbarara was poor as the majority of the participants 90(60%) reported to have never heard about Post Cesarean self-care while only 60 (40%) reported having ever heard about Post Cesarean self-care and no postpartum woman was fully aware of all the aspects of PCS and only 26% could talk of more than 2 aspects of the PCS. The findings of the study also revealed that 22% (33) of the postpartum women don't perform PCS at all. This shows a low practice of PCS among postpartum women. Conclusion and recommendations: Generally, in this study, the knowledge of post-cesarean section self-care among postpartum women at MRRH in Mbarara was poor, suggesting that these postpartum women are unaware of the value of this personal health promotion tool.

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Evaluating capacity at three government referral hospital emergency units in the Kingdom of Eswatini using the WHO Hospital Emergency Unit Assessment Tool

10.21203/rs.2.24172/v1 ◽

2020 ◽

Author(s):

Jennifer Pigoga ◽

Anjni Patel Joiner ◽

Phindile Chowa ◽

Jennifer Luong ◽

Masitsela Mhlanga ◽

...

Keyword(s):

Emergency Care ◽

Assessment Tool ◽

Care Delivery ◽

Cross Sectional Study ◽

Referral Hospital ◽

Emergency Unit ◽

Hospital Emergency ◽

Cross Sectional ◽

Middle Income ◽

Entry Points

Abstract Background The Kingdom of Eswatini, a lower-middle income nation of 1.45 million in southern Africa, has recently identified emergency care as a key strategy to respond to the national disease burden. We aimed to evaluate the current capacity of hospital emergency care areas using the WHO Hospital Emergency Unit Assessment Tool (HEAT) at government referral hospitals in Eswatini. Methods We conducted a cross-sectional study of three government referral hospital emergency care areas using HEAT in May 2018. This standardised tool assists healthcare facilities to assess the emergency care delivery capacity in facilities and support in identifying gaps and targeting interventions to strengthen care delivery within emergency care areas. Senior-level emergency care area employees, including senior medical officers and nurse matrons, were interviewed using the HEAT. Results All sites provided some level of emergency care 24 hours a day, seven days a week, though most had multiple entry points for emergency care. Only one facility had a dedicated area for receiving emergencies and a dedicated resuscitation area; two had triage areas. Facilities had limited capacity to perform signal functions (life-saving procedures that require both skills and resources). Commonly reported barriers included training deficits and lack of access to supplies, medications, and equipment. Sites also lacked formal clinical management and process protocols (such as triage and clinical protocols). Conclusions The HEAT highlighted strengths and weaknesses of emergency care delivery within hospitals in Eswatini and identified specific causes of these system and service gaps. In order to improve emergency care outcomes, multiple interventions are needed, including training opportunities, improvement in supply chains, and implementation of clinical and process protocols for emergency care areas. We hope that these findings will allow hospital administrators and planners to develop effective change management plans.

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Delays in diagnosis and treatment of pulmonary tuberculosis in patients seeking care at a regional referral hospital, Uganda: a cross sectional study

BMC Research Notes ◽

10.1186/s13104-019-4616-2 ◽

2019 ◽

Vol 12 (1) ◽

Author(s):

Winters Muttamba ◽

Samuel Kyobe ◽

Alimah Komuhangi ◽

James Lakony ◽

Esther Buregyeya ◽

...

Keyword(s):

Health Facility ◽

Cross Sectional Study ◽

Patient Delay ◽

Referral Hospital ◽

Cross Sectional Survey ◽

Total Delay ◽

Cross Sectional ◽

Treatment Unit ◽

Regional Referral Hospital ◽

Tb Treatment

Abstract Objective A cross-sectional survey involving 134 pulmonary TB patients started on TB treatment at the TB Treatment Unit of the regional referral hospital was conducted to ascertain the prevalence of individual and health facility delays and associated factors. Prolonged health facility delay was taken as delay of more than 1 week and prolonged patient delay as delay of more than 3 weeks. A logistic regression model was done using STATA version 12 to determine the delays. Results There was a median total delay of 13 weeks and 110 (82.1%) of the respondents had delay of more than 4 weeks. Patient delay was the most frequent and greatest contributor of total delay and exceeded 3 weeks in 95 (71.6%) respondents. At multivariate analysis, factors that influenced delay included poor patient knowledge on TB (adjOR 6.904, 95% CI 1.648–28.921; p = 0.04) and being unemployed (adjOR 3.947, 95% CI 1.382–11.274; p = 0.010) while being female was found protective of delay; adjOR 0.231, 95% CI 0.08–0.67; p = 0.007). Patient delay was the most significant, frequent and greatest contributor to total delay, and factors associated with delay included being unemployed, low knowledge on TB while being female was found protective of delay.

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PREVALENCE AND FACTORS ASSOCIATED WITH ROUTINE MEDICAL CHECKUP AMONG PATIENTS ATTENDING MASAKA REGIONAL REFERRAL HOSPITAL, UGANDA

International Journal of Advanced Research ◽

10.21474/ijar01/13104 ◽

2021 ◽

Vol 9 (07) ◽

pp. 97-105

Author(s):

Aremu A.B. ◽

◽

Afolabi I.B ◽

Salaam M. Awunor N.S ◽

Sulayman A.A ◽

...

Keyword(s):

Early Death ◽

Well Being ◽

Cross Sectional Study ◽

Health Check ◽

Referral Hospital ◽

Cross Sectional ◽

Regional Referral Hospital ◽

Mortality And Morbidity ◽

Medical Checkup ◽

Early Health

Globally, Routine Medical checkup is known to be a preventive medicine that opens doors for assessment of well-being status of all individual and decreases the mortality and morbidity of different ailments in communities. attending health checkups may be one of the key reasons of controlling the predisposition and cause of much of the illness, suffering and early death related to chronic illnesses and condition. Its on this ground that this current study sought to elucidate further on factors determining the adherence of people to medical checkups. A descriptive cross-sectional study was carried out among 385 adult respondents attending Masaka regional referral hospital, in Uganda. A structured questionnaire involving open-ended and close-ended questionnaire was used and data was analyzed using SPSS version 26. Overall, 61.3% of study participants have ever heard of routine health check-ups citing hospitals (25.7%) as the most used source of the information. A prevalence of 43.4% represents the percentage of those who do routine health check-up and of which majority engage in only a general examination (14.5%). Overall, more than half of the respondents (56.6%) have never participated in routine health check-ups with their reported reasons of not feeling sick (25.97%). Factors like level of education, Employment, Occupational, exercise practices and level of awareness was statistically significant to uptake of routine heath checkup among the respondent at P< (0.005). Low health check-up rates may translate into inability to detect and intervene with early health challenges among respondents, and this is whereeffort is needed in ensuring that routine health check-up is encouraged especially during times when patients are healthy. There is need to strengthen government efforts and other concerned NGOs to put across specific sensitization programs about routine health check-ups on different media platforms and also utilize other social public means.

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Perceptions of hospital staff on the performance of Quality Improvement teams in the regional referral hospitals in Tanzania: A cross sectional study

PLoS ONE ◽

10.1371/journal.pone.0246927 ◽

2021 ◽

Vol 16 (2) ◽

pp. e0246927

Author(s):

Godfrey Kacholi ◽

Ozayr H. Mahomed

Keyword(s):

Logistic Regression ◽

Quality Improvement ◽

Quality Care ◽

Hospital Staff ◽

Cross Sectional Study ◽

Public Hospitals ◽

Sectional Study ◽

Multivariate Logistic Regression ◽

Cross Sectional ◽

Referral Hospitals

Background To ensure patient-centered quality care for all citizens, Quality Improvement (QI) teams have been established across all public hospitals in Tanzania. However, little is known about how hospital staff perceive the performance of hospital QI teams in Tanzania. This study assessed the perceptions of hospital staff of the performance of QI teams in selected regional referral hospitals in Tanzania. Methods This cross-sectional study was conducted in four selected regional referral hospitals between April and August 2018. A self-administered questionnaire was used to collect data from 385 hospital staff in the selected hospitals. Measures of central tendency, proportions and frequencies were used to assess level of perception of hospital staff. Bivariate and multivariate logistic regression was used to test the association between the perceptions of hospital staff of the performance of QI teams and their socio-demographic factors. Results The overall mean perception score of the performance of QI teams was 4.84 ± 1.25. Hospital staff aged 35 and over (n = 130; 68%), female hospital staff (n = 144; 64%), staff in clinical units (n = 136; 63%) and staff with post-secondary education (n = 175; 63%) perceived that the performance of QI teams was good. Improved hospital cleanliness was viewed as strength of QI teams, whilst inadequate sharing of information and inadequate reduction in patient waiting time were considered as weaknesses of QI team performance. Bivariate and multivariate logistic regression analyses showed that there was no statistical association between the perceptions of hospital staff and their socio-demographic characteristics. Conclusion The overall perception of hospital staff of the performance of QI teams was good, with the main limitation being sharing of hospital QI plans with hospital staff. Hospital staff should be involved in the development and implementation of hospital QI plans, which would promote a positive perception of staff of the performance of QI teams and enhance sustainability of QI teams.

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Early Malaria diagnosis and treatment seeking Behavior among clients attending outpatient department Sekou-Toure regional referral Hospital in Mwanza, Tanzania; A Cross-Sectional Study

10.21203/rs.3.rs-1241937/v1 ◽

2022 ◽

Author(s):

Samson Peter Mvandal ◽

Gotfrida Marandu

Keyword(s):

Health Facility ◽

Early Treatment ◽

Malaria Diagnosis ◽

Cross Sectional Study ◽

Referral Hospital ◽

Treatment Seeking ◽

Sectional Study ◽

Cross Sectional ◽

Regional Referral Hospital ◽

Seeking Behavior

Abstract Background Early diagnosis of malaria and treatment seeking behavior play key role in controlling and preventing further complication related to malaria disease. Aim of this study was to determine the responses on early malaria diagnosis and treatment seeking behavior among outpatient clients attending at Sekou toure regional referral hospital in Mwanza, Tanzania. Methods A cross-sectional study was conducted among outpatient client at Sekou-Touré regional referral hospital, convenient simple random sampling used and self-administered questionnaire were used to collect data and data was entered into Microsoft excel and then exported to SPSS version 25.0 for further analysis and presented on the percentages and table. The analysis of strength of relationships between categorical variables was conducted using the Chi-square test. A p-value of ≤ 0.05 was considered to be statistically significant. Results A total of 192 respondents completed the study with a response rate of 97.6%. The study revealed that Most of the respondents about 90.6% stated they would seek treatment from health facility when symptoms appear. However, only 6.3% seek treatment within 24 hours of onset of illness (p= 0.017). Half of respondents (50.5%) experienced malaria symptoms in the past six months and only 30% seek for treatment at health facility. Preference of health facility, (51%) respondents were going direct to pharmacy to buy medicine for self-treatment. Overall, cost of service, time consumed and distance of health facility especially health center shows significant with such delay. Conclusion A low proportion of malaria-suspected patients sought treatment within 24 h of fever onset compared to the national target. Distance from the health facility, cost of service and time consumed were found to be predictors of early treatment-seeking behavior for malaria. Strengthening strategies tailored to increasing awareness for communities about malaria, importance of going hospital and early treatment-seeking behavior is essential.

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Chronic Osteomyelitis among Children Attending Orthopedic Services at Mbarara Regional Referral Hospital: Prevalence, Etiological Agents and Their Drug Susceptibility Patterns

Microbiology Research Journal International ◽

10.9734/mrji/2019/v28i530144 ◽

2019 ◽

pp. 1-14

Author(s):

Tayebwa Edson ◽

Kisitu Kyengera ◽

Baguma Andrew ◽

Bazira Joel

Keyword(s):

Staphylococcus Aureus ◽

Chronic Osteomyelitis ◽

Drug Susceptibility ◽

Cross Sectional Study ◽

Referral Hospital ◽

Cross Sectional ◽

Regional Referral Hospital ◽

Causative Agents ◽

Etiological Agents ◽

Susceptibility Patterns

Background: This cross-sectional study was conducted to determine prevalence, causative agents and their drug susceptibility patterns of chronic osteomyelitis children among 766 children attending orthopedic services at Mbarara Regional Referral Hospital between October 2016 and June 2017. Methods: Seventy-four consented patients were consecutively enrolled and their demographic characteristics, clinical and radiological data collected. Superficial and deep bone pus swabs were collected and processed as per standard operative procedures. Susceptibility testing was done using the Kirby Bauer disc diffusion technique. Data was analyzed using Stata version 13.0. Results: The prevalence of children with COM was 9.7%. The female: Male ratio was 1:1.2 with a mean age of 11 years. The most infected bone was the tibia followed by the femur. The common clinical presentations were chronic bone pain and discharging sinus tracts whereas the most imminent radiological features were sequestrum and involcrum. Pus swabs were taken off from both the discharging sinuses and the deep intra osseous abscesses for culture and sensitivity studies. The concordance rate of the microorganisms between the superficial and the deep swabs was 62.5%. Staphylococcus aureus was the most predominant microorganism isolated (85%). All the microorganism isolates were sensitive to gentamycin. However, all Staphylococcus aureus isolated were resistant to penicillin. Conclusion: Prevalence of Chronic osteomyelitis among children with orthopedic conditions presenting to MRRH is high. The isolated microorganisms are resistant to antibiotics we commonly use in our settings.

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