scholarly journals Health systems readiness to provide geriatric friendly care services in Uganda: a cross-sectional study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Jude Thaddeus Ssensamba ◽  
Moses Mukuru ◽  
Mary Nakafeero ◽  
Ronald Ssenyonga ◽  
Suzanne N. Kiwanuka
Keyword(s):  
Public Health ◽  
Health System ◽  
Health Facility ◽  
Health Systems ◽  
Building Blocks ◽  
Health Facilities ◽  
Health Centers ◽  
World Health ◽  
Care Services ◽  
Southern Central

Abstract Background As ageing emerges as the next public health threat in Africa, there is a paucity of information on how prepared its health systems are to provide geriatric friendly care services. In this study, we explored the readiness of Uganda’s public health system to offer geriatric friendly care services in Southern Central Uganda. Methods Four districts with the highest proportion of old persons in Southern Central Uganda were purposively selected, and a cross-section of 18 randomly selected health facilities (HFs) were visited and assessed for availability of critical items deemed important for provision of geriatric friendly services; as derived from World Health Organization’s Age-friendly primary health care centres toolkit. Data was collected using an adapted health facility geriatric assessment tool, entered into Epi-data software and analysed using STATA version 14. Kruskal-Wallis and Dunn’s post hoc tests were conducted to determine any associations between readiness, health facility level, and district. Results The overall readiness index was 16.92 (SD ±4.19) (range 10.8–26.6). This differed across districts; Lwengo 17.91 (SD ±3.15), Rakai 17.63 (SD ±4.55), Bukomansimbi 16.51 (SD ±7.18), Kalungu 13.74 (SD ±2.56) and facility levels; Hospitals 26.62, Health centers four (HCIV) 20.05 and Health centers three (HCIII) 14.80. Low readiness was due to poor scores concerning; leadership (0%), financing (0%), human resources (1.7%) and health management information systems (HMIS) (11.8%) WHO building blocks. Higher-level HFs were statistically significantly friendlier than lower-level HFs (p = 0.015). The difference in readiness between HCIIIs and HCIVs was 2.39 (p = 0.025). Conclusion There is a low readiness for public health facilities to provide geriatric friendly care services in Uganda. This is due to gaps in all of the health system building blocks. There is a need for health system reforms in Uganda to adequately cater for service provision for older adults if the 2020 global healthy ageing goal is to be met.

scholarly journals Health systems readiness to provide geriatric friendly care services in Uganda: a cross-sectional study

2019 ◽  
Author(s):  
Jude Thaddeus Ssensamba ◽  
Moses Mukuru ◽  
Mary Nakafeero ◽  
Ronald Ssenyonga ◽  
Suzanne N Kiwanuka
Keyword(s):  
Public Health ◽  
Health System ◽  
Health Facility ◽  
Health Systems ◽  
Building Blocks ◽  
Health Facilities ◽  
Health Centers ◽  
World Health ◽  
Care Services ◽  
Southern Central

Abstract Background As ageing emerges as the next public health threat in Africa, there is a paucity of information on how prepared its health systems are to provide geriatric friendly care services. In this study, we explored the readiness of Uganda’s public health system to provide geriatric friendly care services in Southern Central Uganda. Methods Four districts with the highest proportion of old persons in Southern Central Uganda were purposively selected, and a cross section of 18 randomly selected health facilities (HFs) were visited and assessed for availability of key items deemed important for provision of geriatric friendly services; as derived from World Health Organization’s Age-friendly primary health care centres toolkit. Data was collected using an adapted health facility geriatric assessment tool, entered into Epi-data software and analysed using STATA version 14. Kruskal-Wallis and Dunn’s post hoc tests were conducted to determine any associations between readiness, health facility level and district. Results The overall readiness index was 16.92 (SD ±4.19) (range 10.8 - 26.6). This differed across districts; Lwengo 17.91 (SD ±3.15), Rakai 17.63 (SD ±4.55), Bukomansimbi 16.51 (SD ±7.18), Kalungu 13.74 (SD ±2.56) and facility levels; Hospitals 26.62, Health centers four (HCIV) 20.05 and Health centers three (HCIII) 14.80. Low readiness was due to poor scores with regard to; leadership (0%), financing (0%), human resources (1.7%) and health management information systems (HMIS) (11.8%) WHO building blocks. Higher level HFs were statistically significantly friendlier than lower level HFs (p= 0.015). The difference in readiness between HCIIIs and HCIVs was 2.39 (p=0.025). Conclusion There is low readiness of public health facilities to provide geriatric friendly care services in Uganda. This is due to gaps in all of the health system building blocks. There is a need for health system reforms in Uganda to adequately cater for service provision for old people if the 2020 global healthy ageing goal is to be met.

scholarly journals Health systems readiness to provide geriatric friendly care services in Uganda: a cross-sectional study

2019 ◽  
Author(s):  
Jude Thaddeus Ssensamba ◽  
Moses Mukuru ◽  
Mary Nakafeero ◽  
Ronald Ssenyonga ◽  
Suzanne N Kiwanuka
Keyword(s):  
Public Health ◽  
Health System ◽  
Health Facility ◽  
Health Systems ◽  
Building Blocks ◽  
Health Facilities ◽  
Health Centers ◽  
World Health ◽  
Care Services ◽  
Southern Central

Abstract Background As ageing emerges as the next public health threat in Africa, there is a paucity of information on how prepared its health systems are to provide geriatric friendly care services. In this study, we explored the readiness of Uganda’s public health system to provide geriatric friendly care services in Southern Central Uganda. Methods Four districts with the highest proportion of old persons in Southern Central Uganda were purposively selected, and a cross section of 18 randomly selected health facilities (HFs) were visited and assessed for availability of key items deemed important for provision of geriatric friendly services; as derived from World Health Organization’s Age-friendly primary health care centres toolkit. Data was collected using an adapted health facility geriatric assessment tool, entered into Epi-data software and analysed using STATA version 14. Kruskal-Wallis and Dunn’s post hoc tests were conducted to determine any associations between readiness, health facility level and district. Results The overall readiness index was 16.92 (SD ±4.19) (range 10.8 - 26.6). This differed across districts; Lwengo 17.91 (SD ±3.15), Rakai 17.63 (SD ±4.55), Bukomansimbi 16.51 (SD ±7.18), Kalungu 13.74 (SD ±2.56) and facility levels; Hospitals 26.62, Health centers four (HCIV) 20.05 and Health centers three (HCIII) 14.80. Low readiness was due to poor scores with regard to; leadership (0%), financing (0%), human resources (1.7%) and health management information systems (HMIS) (11.8%) WHO building blocks. Higher level HFs were statistically significantly friendlier than lower level HFs (p= 0.015). The difference in readiness between HCIIIs and HCIVs was 2.39 (p=0.025). Conclusion There is low readiness of public health facilities to provide geriatric friendly care services in Uganda. This is due to gaps in all of the health system building blocks. There is a need for health system reforms in Uganda to adequately cater for service provision for old people if the 2020 global healthy ageing goal is to be met.

scholarly journals Health systems readiness to provide geriatric friendly care services in Uganda: a cross-sectional study

2019 ◽  
Author(s):  
Jude Thaddeus Ssensamba ◽  
Moses Mukuru ◽  
Mary Nakafeero ◽  
Ronald Ssenyonga ◽  
Suzanne N Kiwanuka
Keyword(s):  
Public Health ◽  
Health System ◽  
Health Facility ◽  
Health Systems ◽  
Building Blocks ◽  
Health Facilities ◽  
Health Centers ◽  
World Health ◽  
Care Services ◽  
Southern Central

Abstract Background As ageing emerges as the next public health threat in Africa, there is a paucity of information on how prepared its health systems are to provide geriatric friendly care services. In this study, we explored the readiness of Uganda’s public health system to provide geriatric friendly care services in Southern Central Uganda. Methods Four districts with the highest proportion of old persons in Southern Central Uganda were purposively selected, and a cross section of 18 randomly selected health facilities (HFs) were visited and assessed for availability of key items deemed important for provision of geriatric friendly services; as derived from World Health Organization’s Age-friendly primary health care centres toolkit. Data was collected using an adapted health facility geriatric assessment tool, entered into Epi-data software and analysed using STATA version 14. Kruskal-Wallis and Dunn’s post hoc tests were conducted to determine any associations between readiness, health facility level and district. Results The overall readiness index was 16.92 (SD ±4.19) (range 10.8 - 26.6). This differed across districts; Lwengo 17.91 (SD ±3.15), Rakai 17.63 (SD ±4.55), Bukomansimbi 16.51 (SD ±7.18), Kalungu 13.74 (SD ±2.56) and facility levels; Hospitals 26.62, Health centers four (HCIV) 20.05 and Health centers three (HCIII) 14.80. Low readiness was due to poor scores with regard to; leadership (0%), financing (0%), human resources (1.7%) and health management information systems (HMIS) (11.8%) WHO building blocks. Higher level HFs were statistically significantly friendlier than lower level HFs (p= 0.015). The difference in readiness between HCIIIs and HCIVs was 2.39 (p=0.025). Conclusion There is low readiness of public health facilities to provide geriatric friendly care services in Uganda. This is due to gaps in all of the health system building blocks. There is a need for health system reforms in Uganda to adequately cater for service provision for old people if the 2020 global healthy ageing goal is to be met.

scholarly journals What makes health systems resilient against infectious disease outbreaks and natural hazards? Results from a scoping review

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Jennifer B. Nuzzo ◽  
Diane Meyer ◽  
Michael Snyder ◽  
Sanjana J. Ravi ◽  
Ana Lapascu ◽  
...  
Keyword(s):  
Public Health ◽  
Infectious Disease ◽  
Health System ◽  
Natural Hazards ◽  
Health Systems ◽  
Scoping Review ◽  
Disease Outbreaks ◽  
World Health ◽  
Infectious Disease Outbreaks ◽  
System Resilience

Abstract Background The 2014–2016 Ebola outbreak was a wake-up call regarding the critical importance of resilient health systems. Fragile health systems can become overwhelmed during public health crises, further exacerbating the human, economic, and political toll. Important work has been done to describe the general attributes of a health system resilient to these crises, and the next step will be to identify the specific capacities that health systems need to develop and maintain to achieve resiliency. Methods We conducted a scoping review of the literature to identify recurring themes and capacities needed for health system resiliency to infectious disease outbreaks and natural hazards and any existing implementation frameworks that highlight these capacities. We also sought to identify the overlap of the identified themes and capacities with those highlighted in the World Health Organization’s Joint External Evaluation. Sources of evidence included PubMed, Web of Science, OAIster, and the websites of relevant major public health organizations. Results We identified 16 themes of health system resilience, including: the need to develop plans for altered standards of care during emergencies, the need to develop plans for post-event recovery, and a commitment to quality improvement. Most of the literature described the general attributes of a resilient health system; no implementation frameworks were identified that could translate these elements into specific capacities that health system actors can employ to improve resilience to outbreaks and natural hazards in a variety of settings. Conclusions An implementation-oriented health system resilience framework could help translate the important components of a health system identified in this review into specific capacities that actors in the health system could work to develop to improve resilience to public health crises. However, there remains a need to further refine the concept of resilience so that health systems can simultaneously achieve sustainable transformations in healthcare practice and health service delivery as well as improve their preparedness for emergencies.

scholarly journals Management of chronic lung diseases in Sudan and Tanzania: how ready are the country health systems?

2021 ◽  
Author(s):  
Uzochukwu Egere ◽  
Elizabeth Shayo ◽  
Nyanda Ntinginya ◽  
Rashid Osman ◽  
Bandar Noory ◽  
...  
Keyword(s):  
Health System ◽  
Health Facility ◽  
Health Systems ◽  
Lung Diseases ◽  
Health Centre ◽  
Sub Saharan Africa ◽  
World Health ◽  
Service Availability ◽  
Chronic Lung Diseases ◽  
Service Readiness

Abstract BackgroundChronic Lung Diseases (CLDs), responsible for 4 million deaths globally every year, are increasingly important in low- and middle-income countries where most of the global mortality due to CLDs currently occurs. As existing health systems in resource-poor contexts, especially sub-Saharan Africa (SSA), are not generally oriented to provide quality care for chronic diseases, a first step in re-imagining them is to critically consider readiness for service delivery across all aspects of the existing system. MethodsWe conducted a mixed-methods assessment of CLD service readiness in 18 purposively selected health facilities in two differing SSA health system contexts, Tanzania and Sudan. We used the World Health Organization’s (WHO) Service Availability and Readiness Assessment checklist, qualitative interviews of key health system stakeholders, health facility registers review and assessed clinicians’ capacity to manage CLD using patient vignettes. CLD service readiness was scored as a composite of availability of service-specific tracer items from the WHO service availability checklist in three domains: staff training and guidelines, diagnostics and equipment, and basic medicines. Qualitative data were analysed using the same domains.ResultsOne health facility in Tanzania and five in Sudan, attained a CLD readiness score of ≥50% for CLD care. Scores ranged from 14.9% in a dispensary to 53.3% in a health centre in Tanzania, and from 36.4% to 86.4% in Sudan. The least available tracer items across both countries were trained human resources and guidelines, and peak flow meters. Only two facilities had COPD guidelines. Patient vignette analysis revealed significant gaps in clinicians’ capacity to manage CLD. Key informants identified low prioritization as key barrier to CLD care. Conclusion: Gaps in service availability and readiness for CLD care in Tanzania and Sudan threaten attainment of universal health coverage in these settings. Detailed assessments by health systems researchers in discussion with stakeholders at all levels of the health system can identify critical blockages to reimagining CLD service provision with people-centred, integrated approaches at its heart.

scholarly journals Availability of emergency obstetric and newborn care services at public health facilities of Sindh province in Pakistan

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Ramesh Kumar ◽  
Jamil Ahmed ◽  
Fozia Anwar ◽  
Ratana Somrongthong
Keyword(s):  
Public Health ◽  
Caesarean Section ◽  
Blood Transfusion ◽  
Neonatal Resuscitation ◽  
Newborn Care ◽  
Health Facilities ◽  
World Health ◽  
Public Health Facilities ◽  
Care Services ◽  
Sindh Province

Abstract Background Basic and comprehensive emergency obstetric care services in Pakistan remain a challenge considering continued high burden of maternal and newborn mortality. This study aimed to assess the availability of emergency obstetric and newborn care in Sindh Province of Pakistan. Methods This cross-sectional survey was conducted in twelve districts of the Sindh province in Pakistan. The districts were selected based on the maternal neonatal and child health indicators. Data were collected from 63 public-sector health facilities including district, Taluka (subdistrict) headquarters hospitals and rural health centers. Basic and comprehensive emergency obstetric newborn care services were assessed through direct observations and interviews with the heads of the health facilities by using a World Health Organization pretested and validated data collection tool. Participants interviewed in this study included the managers and auxiliary staff and in health facilities. Results Availability of caesarean section (23, 95% C.I. 14.0–35.0) and blood transfusion services (57, 95% CI. 44.0–68.0), the two components of comprehensive emergency obstetric and newborn care, was poor in our study. However, assessment of the seven components of basic emergency obstetric and newborn services showed that 92% of the health facilities (95% C.I. 88.0–96.0) had parenteral antibiotics, 90%, (95% C.I. 80.0–95.0) had oxytocin, 92% (95% CI 88.0–96.0) had manual removal of the placenta service, 87% (95%, C.I. 76.0–93.0) of the facilities had staff who could remove retained products of conception, 82% (95% C.I. 71.0–89.0) had facilities for normal birth and 80% (95% C.I. 69.0–88.0) reported presence of neonatal resuscitation service. Conclusion Though the basic obstetric and newborn services were reasonably available, comprehensive obstetric and newborn services were not available as per the World Health Organization’s standards in the surveyed public health facilities. Ensuring the availability of caesarean section and blood transfusion services within these facilities may improve population’s access to these essential services around birth.

scholarly journals Strengthening health system building blocks: configuring post-COVID-19 scenario in Pakistan

2021 ◽  
Vol 22 ◽  
Author(s):  
Babar Tasneem Shaikh
Keyword(s):  
Public Health ◽  
Developing Countries ◽  
Health System ◽  
Emergency Preparedness ◽  
Virus Disease ◽  
Building Blocks ◽  
Research Capacity ◽  
Control Measures ◽  
World Health ◽  
The Government

Abstract Aim: To gauge the level of preparedness of health system of Pakistan in the wake of Corona Virus Disease 2019 (COVID-19) pandemic. Background: The global COVID-19 outbreak and its subsequent repercussions and implications, after being declared as a pandemic by the World Health Organization (WHO), exposed all the inherent, lingering, and acute shortcomings of the health systems in many developing countries and Pakistan was no exception. Methods: A detailed literature review was done which included peer-reviewed articles on COVID-19 and health system, published in local and international journals, WHO and World Bank’s publications, and the documents and official reports of the government. Focus was to glean and cite strategies adopted by the developing countries in response to COVID-19 and to see the applicability of those which are feasible for Pakistan. Findings: Level of preparedness was minimal and the response to manage the outbreak was weak. Based on toll of the cases and number of deaths, this public health threat turned out to be a catastrophe beyond the controlling authority and capacity of the health system, and hence other sectors and agencies had to be engaged for devising a concerted and integrated response to deal with the emergency. Governance was disorderly, financing was inadequate, human resources were not trained, supplies and logistic were not stocked, information system was patchy, and research capacity was limited, and most of all the service delivery was in a biggest chaos of times. COVID-19 demanded to re-configure the health system of Pakistan. Conclusion: Improving the emergency preparedness of the hospitals is the foremost and an urgent need. A strong national public health system in Pakistan is needed to rapidly investigate and analyze the reports, assess the magnitude of the public health risk, share real-time information, and implement public health control measures in a concerted and systematic demeanor.

scholarly journals Implementation of Tuberculosis Infection Control Practices in Tuberculosis Diagnostic and Treatment Health Facilities in Kampala District, Uganda, August 2015

2020 ◽  
Author(s):  
Didas Tugumisirize ◽  
Stavia Turyahabwe ◽  
Lilian Bulage ◽  
Stella Zawedde Muyanja ◽  
Robert Kaos Majwala ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Infection Control ◽  
Health Facility ◽  
Health Workers ◽  
Health Care Facilities ◽  
Health Facilities ◽  
Tuberculosis Infection ◽  
Care Services ◽  
Tuberculosis Infection Control

AbstractBackgroundEffective implementation of Tuberculosis infection control (TB IC) measures in health facilities delivering TB care services is very critical in controlling nosocomial transmission of TB infections among health workers, patients and their attendants. The aim of the study was to assess and document the implementation of TB IC practices in TB diagnostic and treatment health facilities in Kampala District, which accounts for 15-20% of the total TB burden in Uganda.MethodsIn August 2015, we conducted a cross-sectional study in 25 health facilities including 07 Public and 18 Private healthcare facilities in Kampala. We used a modified checklist adopted from the national manual for implementing TB control measures in health care facilities. We reviewed health facility records and where necessary observed TB IC practices to triangulate our findings. We conducted univariate analysis and generated proportions in order to describe the extent of implementation of TB IC measures.ResultsOn average, 73% of both administrative and managerial, 65% environmental, and 56% personal protective TB IC measures were complied with at the health facilities visited. Private health facilities implemented 71% of both administrative and managerial TBIC measures compared to public health facilities (31%). Thirty Six percent of health facilities reported that they were regularly screening health care workers for TB. By Observation, 28% had TB IC guideline, 36% had TB IC plan, 12% had a designated area for sputum collection, 56% were regularly opening windows, 40% had fans installed in the waiting areas and/or consultation rooms and 24% had bio-safety cabinets fitted with UV light. In addition, 60% had N95 respirators but only 32% of the facilities reported that their health workers routinely wore them.ConclusionImplementation of WHO recommended TB IC measures in health facilities delivering TB care services in Kampala was sub optimal. Routine involvement of health facility management as well as increasing human resources for health is critical in implementing easy to do TBIC measures like triaging, patients’ educating on coughing etiquette and respiratory hygiene and daily window opening particularly in public health care settings where implementation of administrative TB IC measures is wanting

scholarly journals Examining Health Facility Financing in Kenya in the Context of Devolution

2021 ◽  
Author(s):  
Angela Kairu ◽  
Stacey Orangi ◽  
Boniface Mbuthia ◽  
Joanne Ondera ◽  
Nirmala Ravishankar ◽  
...  
Keyword(s):  
Health System ◽  
Health Facility ◽  
Descriptive Analysis ◽  
Health Facilities ◽  
Public Hospitals ◽  
Health Centers ◽  
User Fees ◽  
Public Facility ◽  
Cross Sectional ◽  
Financial Autonomy

Abstract Background: How health facilities are financed affects their performance and health system goals. We examined how health facilities in the public sector are financed in Kenya, within the context of a devolved health system.Methods: We carried out a cross-sectional study in five purposely selected counties in Kenya, using a mixed methods approach. We collected data using document reviews and in-depth interviews (no=20). In each county, we interviewed county department of health managers and health facility managers from two and one purposely selected public hospitals and health center respectively. We analyzed qualitive data using thematic analysis and conducted descriptive analysis of quantitative data.Results: Planning and budgeting: Planning and budgeting processes by hospitals and health centers were not standardized across counties. Budgets were not transparent and credible, but rather were regarded as “wish lists” since they did not translate to actual resources. Sources of funds: Public hospitals relied on user fees, while health centers relied on donor funds as their main sources of funding. Funding flows: Hospitals in four of the five study counties had no financial autonomy. Health centers in all study counties had financial autonomy. Flow of funds to hospitals and health centers in all study counties was characterized by unpredictability of amounts and timing. Health facility expenditure: Staff salaries accounted for over 80% of health facility expenditure. This crowded out other expenditure and led to frequent stock outs of essential health commodities. Conclusion: The national and county government should consider improving health facility financing in Kenya by 1) standardizing budgeting and planning processes, 2) transitioning public facility financing away from a reliance on user fees and donor funding 3) reforming public finance management laws and carry out political engagement to facilitate direct facility financing and financial autonomy of public hospitals, and 4) assess health facility resource needs to guide appropriate levels resource allocation.

scholarly journals (A287) Who Regional Office for Europe - Health Systems Crisis Preparedness Assessment Tool

2011 ◽  
Vol 26 (S1) ◽  
pp. s80-s80 ◽  
Author(s):  
C.P. Bayer ◽  
G. Rockenschaub
Keyword(s):  
Health System ◽  
Health Systems ◽  
Assessment Tool ◽  
Building Blocks ◽  
World Health ◽  
Current Status ◽  
Sudden Increase ◽  
Crisis Preparedness ◽  
Future Health ◽  
Regional Office

WHO Regional Office for Europe - Health Systems Crisis Preparedness Assessment Tool Bayer CP, Rockenschaub G.ObjectivesHealth crises are often unpredictable and may occur at any place or time. Communities are particularly vulnerable when local and national systems, specifically health systems, are unable to cope with the consequences of a crisis, usually because they are overwhelmed by a sudden increase in demand or because the institutions that underpin them are fragile and cannot deliver what is required. The World Health Organization (WHO) Europe Health System Crisis Preparedness Assessment Tool aims to provide guidance to ministries of health and other relevant authorities on evaluation and strengthening of their health system's capacities for crisis management.MethodsBased on an all hazard approach, an assessment tool was developed which comprises essential attributes considered vital for countries to meet the challenges of future health crises. The foundation of the tool derived from expert consultation workshops and pilot testing in eight countries in the WHO European Region.ResultsThe tool lists essential attributes with respective indicators crucial for evaluating and identifying gaps in health system crisis preparedness. The assessment tool is structured according to the six building blocks of the WHO health system framework and is complemented by a user manual, allowing countries to apply a self–assessment approach. The tool is intended for use by ministries of health or other relevant institutions.ConclusionsThe tool may help determine the current status of health system crisis preparedness and facilitate the development of a prioritized plan of action that addresses any gaps identified. When used regularly the tool will help monitor progress.

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