Health Policy and Development Department of Health Sciences of Uganda Martyrs University ISSN: 1728-6107 EISSN: 2073-0683 Vol. 7, Num. 3, 2009, pp. 215-216

Health Policy and Development, Vol. 7, No. 3, September-December, 2009, pp. 215-216

Recent Relevant International Publications

Recent Relevant International Publications

Code Number: hp09018

Incentives and barriers to Implementing National Hospital standards in Uganda

Moses Bateganya, Amy Hagopian, Paulatavrow, Samuel Luboga and Scott Barnhart

International Journal for Quality in Health Care 2009 ; Volume 21, Number 6: pp. 421-426

This paper reports on a study to determine the knowledge and attitudes of key Ugandan hospital managerial staff about adoption of new quality standards. It shows that the staff are willing to adopt new standards but they emphasise that new standards should be accompanied by incentives for the staff in order to maintain their commitment to the quality assurance process. Cited incentives include technical assistance, training and financing.

Code of ethics for Government of Uganda internal auditors, may 2009

(available from http://www.finance.go.ug/docs/CODE OF ETHICS FOR GOVERNMENT OF UGANDA INTERNAL AUDITORS.pdf)

Following multiple complaints of corruption in the Uganda government, it has taken a number of steps to improve the image of public services. One of these steps is the introduction of a national ethical code for government internal auditors. The code highlights international professional standards of internal auditors and also appeals to soft values of individual auditors. It is an important document for people with managerial responsibilities.

Combating Judicial Corruption in Uganda

Cynthia A. Baldwin

The Brookings Institution , September 2009.

Corruption is often cited in many sectors of Uganda′s civic life, including in the "sacred temples of justice". This paper, based on interviews with judiciary staff in Uganda, affirms the reports of corruption in the department. However, it also shows a resolve by some key officials of the department to uproot the vice, right from childhood through various approaches, including training.

Agreement between physicians and non-physician clinicians in starting antiretroviral therapy in rural Uganda

Ashwin Vasan, Nathan Kenya-Mugisha, Kwonjune J Seung, Marion Achieng, Patrick Banura, Frank Lule, Megan Beems, Jim Todd and Elizabeth Madraa

Human Resources for Health 2009, 7 :75 doi:10.1186/1478-4491-7-75

This paper highlights the global human resources for health crisis which is worse in sub-Saharan Africa. In line with calls for task-shifting to beat the crisis, the paper reports on a pilot study to test the agreement between doctors and other non-physician health workers in deciding when to start Anti-retroviral therapy. It shows that nurses and clinical officers have strong agreement with doctors in decision-making but cautions that more studies are needed before the task-shifting is scaled up.

Potential impact of task-shifting on costs of antiretroviral therapy and physician supply in Uganda

BMC Health Services Research 2009, 9 :192 doi:10.1186/1472-6963-9-192

This paper also highlights the human resources for health crisis in Uganda and puts the proposal of task-shifting to the test. Using cost-minimization analysis, the study looked at the costs saved by using less-qualified staff to provide antiretroviral therapy and follow up. It finds that task-shifting to non-physician prescribers saves a lot of costs, but it did not compare the quality of care between the two groups.

Training needs assessment for clinicians at antiretroviral therapy clinics: Evidence from a national survey in Uganda

Human Resources for Health 2009, 7 :76 doi:10.1186/1478-4491-7-76

In order to address the human resources for health crisis, task-shifting has been recommended by several sources, with various claims about its success. This study studied a natural experiment in anti-retroviral therapy in Uganda, whereby non-physician clinicians were already prescribing the treatment without waiting for official sanction. It found that many non-physician clinicians were already prescribing anti-retroviral therapy and that they felt the quality of their work was not good enough. The paper recommends that training should be an essential component of task-shifting efforts.

Changes in utilization of health services among poor and rural residents in Uganda: Are reforms benefitting the poor?

George W Pariyo, Elizabeth Ekirapa-Kiracho, Olico Okui, Mohammed Hafizur Rahman, Stefan Peterson, David M Bishai, Henry Lucas and David H Peters

International Journal for Equity in Health 2009, 8 :39 doi:10.1186/1475-9276-8-39

Over the last 15 years, Uganda has made several reforms in health policy with a view to increase access to health care. Reports show that indeed, access has increased but without much analysis of who accesses the services. This paper analysed the users of health care in a selected period and finds that there was a comparatively higher utilization of all services in 2005/6 than in 2002/3, that private for profit providers were the most preferred providers, and that the most marginalized groups were more likely to use public services.

Assessing access barriers to maternal health care: Measuring bypassing to identify health centre needs in rural Uganda

Justin O Parkhurst and Freddie Ssengooba

Health Policy and Planning 2009 ; 24:377-384

With a high maternal mortality ratio of 435/100,000 live births, Uganda is seriously in need of measures to improve, especially, demand-side factors that affect access to maternal services. This paper reports on a study which analysed the actual utilization of maternal services in rural Uganda. It introduces a new indicator, the "bypassing ratio" (the number of women from a facility′s local catchment area who by pass it and deliver in another facility divided by the number of women from that local area who use that facility) as a measure of people′s acceptance of the services offered. The study shows that many women often bypass their local facilities and deliver elsewhere. Use of this indicator can lead health managers to question why their local population bypasses their services and thus lead to quality improvements.

Lack of effective communication between communities and hospitals in Uganda - A qualitative exploration of missing links

Elizeus Rutebemberwa, Elizabeth Ekirapa-Kiracho, Olico Okui, Damien Walker, Aloysius Mutebi and George Pariyo

BMC Health Services Research 2009, 9 :146 doi:10.1186/1472-6963-9-146

This paper highlights the lack of effective communication between the communities living around Ugandan hospitals and hospital staff. It reports how community members fear to give constructive criticism for fear of being harassed or denied services. In the end, not only is the right of the community to exercise their right participate in improving their health, but also their valuable advice is missed by the health system. The paper advocates for regular use of community meetings, rapid appraisal studies and use of community associations as avenues to improve hospital-community communication.

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