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Uganda, United States

Nabiev R.,Karolinska University Hospital | Eshonkhojaeva S.,Karolinska University Hospital | Rakhimi N.,Karolinska University Hospital | Blom R.,Karolinska University Hospital | And 3 more authors.
12th IEEE International Conference on e-Health Networking, Application and Services, Healthcom 2010 | Year: 2010

The World Health Organization in WHAS8.28 e-Health Resolution has called upon the use of low-cost information and communication technology (ICT) to improve the quality of service delivery in low and middle income countries and to build up health worker's capacity especially at the primary health care (PHC) level. Thanks to market demands and technological progress, the cost for computer hardware is decreasing. Due to this progress, project such as ICT4MPOWER can provide low-cost ICT infrastructure to hospitals and rural clinics in Uganda for better health outcomes of the rural population. However, as number of low-cost computers increase, the more maintenance will be needed. Establishing local technical support team to maintain computer infrastructure in rural clinics of developing countries is a big challenge, since rural clinics lack funds to recruit and sustain local technical support team. Sustaining technical support team locally and providing maintenance for implemented ICT infrastructure is one of the reasons why e-health projects are hard to sustain in rural areas of developing countries. Authors present a framework for simple, practical and low-cost maintenance of computer infrastructure applicable in healthcare organizations of low and middle income countries. It includes innovative use of already existing technology (External Hard Drive) and Centralized Technical Support Team (CTST). © 2010 IEEE.

Nsabagasani X.,Makerere University | Ogwal-Okeng J.,Gulu University | Hansen E.H.,Copenhagen University | Mbonye A.,Ministry of Health Uganda | And 3 more authors.
Journal of Pharmaceutical Policy and Practice | Year: 2016

Background: The Integrated Management of Childhood Illnesses is the main approach for treating children in more than 100 low income countries worldwide. In 2007, the World Health Assembly urged countries to integrate 'better medicines for children' into their essential medicines lists and treatment guidelines. WHO regularly provides generic algorithms for IMCI and publishes the Model Essential Medicines List with child-friendly medicines based on new evidence for member countries to adopt. However, the status of 'better medicines for children' within the Integrated Management of Childhood Illnesses approach in Uganda has not been studied. Methods: Qualitative interviews were conducted with: two officials from the ministry of health; two district health officials and, 22 health workers from public health facilities. Interview transcripts were manually analyzed for manifest and latent content. Results: Child-appropriate dosage formulations were not included in the package for the Integrated Management of Childhood Illnesses and ministry officials attributed this to resource constraints and lack of initial guidance from the World Health Organization. Underfunding reportedly undercut efforts to: orient health workers; do support supervision and update treatment guidelines to reflect 'better medicines for children'. Health workers reported difficulties in administering tablets and capsules to under-five children and that's why they preferred liquid oral dosage formulations, suppositories and injections. Conclusions: The IMCI strategy in Uganda was not revised to reflect child-appropriate dosage formulations - a missed opportunity for improving the quality of management of childhood illnesses. Funding was an obstacle to the integration of child-appropriate dosage formulations. Ministry of health should prioritize funding for the Integrated Management of Childhood Illnesses and revising the Essential Medicines and Health Supplies List of Uganda, the Uganda Clinical Guidelines and, the Treatment Charts for the Integrated Management of Childhood Illnesses to reflect child-appropriate dosage formulations. © 2016 The Author(s).

Bwire G.,Control of Diarrheal Diseases Unit | Mwesawina M.,Ministry of Health Malawi | Baluku Y.,Ministry of Health Uganda | Kanyanda S.S.E.,Ministry of Health Malawi | Orach C.G.,Makerere University
PLoS ONE | Year: 2016

Introduction: Cross-border cholera outbreaks are a major public health problem in Sub-Saharan Africa contributing to the high annual reported cholera cases and deaths. These outbreaks affect all categories of people and are challenging to prevent and control. This article describes lessons learnt during the cross-border cholera outbreak control in Eastern and Southern Africa sub-regions using the case of Uganda-DRC and Malawi-Mozambique borders and makes recommendations for future outbreak prevention and control. Materials and Methods: We reviewed weekly surveillance data, outbreak response reports and documented experiences on the management of the most recent cross-border cholera outbreaks in Eastern and Southern Africa sub-regions, namely in Uganda and Malawi respectively. Uganda-Democratic Republic of Congo and Malawi-Mozambique borders were selected because the countries sharing these borders reported high cholera disease burden to WHO. Results: A total of 603 cross-border cholera cases with 5 deaths were recorded in Malawi and Uganda in 2015. Uganda recorded 118 cases with 2 deaths and CFR of 1.7%. The under-fives and school going children were the most affected age groups contributing 24.2% and 36.4% of all patients seen along Malawi-Mozambique and Uganda-DRC borders, respectively. These outbreaks lasted for over 3 months and spread to new areas leading to 60 cases with 3 deaths, CRF of 5%, and 102 cases 0 deaths in Malawi and Uganda, respectively. Factors contributing to these outbreaks were: poor sanitation and hygiene, use of contaminated water, floods and rampant cross-border movements. The outbreak control efforts mainly involved unilateral measures implemented by only one of the affected countries. Conclusions: Cross-border cholera outbreaks contribute to the high annual reported cholera burden in Sub-Saharan Africa yet they remain silent, marginalized and poorly identified by cholera actors (governments and international agencies). The under-fives and the school going children were the most affected age groups. To successfully prevent and control these outbreaks, guidelines and strategies should be reviewed to assign clear roles and responsibilities to cholera actors on collaboration, prevention, detection, monitoring and control of these epidemics. © 2016 Bwire et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Nsabagasani X.,Makerere University | Ogwal-Okeng J.,Gulu University | Mbonye A.,Ministry of Health Uganda | Ssengooba F.,Makerere University | And 3 more authors.
Journal of Pharmaceutical Policy and Practice | Year: 2015

Background: In 2007, the World Health Organization (WHO) launched the ‘make medicines child size’ (MMCS) campaign by urging countries to prioritize procurement of medicines with appropriate strengths for children’s age and weight and, in child-friendly formulations of rectal and flexible oral solid formulations. This study examined policy provisions for MMCS recommendations in Uganda. Methods: This was an in-depth case study of the Ugandan health policy documents to assess provisions for MMCS recommendations in respect to oral and rectal medicine formulations for malaria, pneumonia and diarrhea, the major causes of morbidity and mortality among children in Uganda- diseases that were also emphasized in the MMCS campaign. Asthma and epilepsy were included as conditions that require long term care. Schistomiasis was included as a neglected tropical disease. Content analysis was used to assess evidence of policy provisions for the MMCS recommendations. Results: For most medicines for the selected diseases, appropriate strength for children’s age and weight was addressed especially in the EMHSLU 2012. However, policy documents neither referred to ‘child size medicines’ concept nor provided for flexible oral solid dosage formulations like dispersible tablets, pellets and granules- indicating limited adherence to MMCS recommendations. Some of the medicines recommended in the clinical guidelines as first line treatment for malaria and pneumonia among children were not evidence-based. Conclusion: The Ugandan health policy documents reflected limited adherence to the MMCS recommendations. This and failure to use evidence based medicines may result into treatment failure and or death. A revision of the current policies and guidelines to better reflect ‘child size’, child appropriate and evidence based medicines for children is recommended. © 2015 Nsabagasani et al.; licensee BioMed Central.

Kabatereine N.,Imperial College London | Fleming F.,Imperial College London | Thuo W.,The Global Network for Neglected Tropical Diseases | Tinkitina B.,Ministry of Health Uganda | And 2 more authors.
BMC Research Notes | Year: 2015

Background: Over 200,000 people, most of them infected with Schistosoma mansoni inhabit 150 islands in Lake Victoria in Uganda. Although a programme to control the disease has been ongoing since 2003, its implementation in islands is inadequate due to high transport costs on water. In 2011 and 2012, the Global Network for Neglected Tropical Diseases (GNNTD) through Schistosomiasis Control Initiative (SCI) provided financial support to ease treatment delivery on the islands and over the period, therapeutic coverage has been increasing. We conducted a study with an objective to assess community awareness of existence of the disease, its signs, symptoms, causes and transmission as well as attitude, practice and health seeking behavior. Methods: This was a cross sectional descriptive study which used pre-tested interviewer administered questionnaire among purposively selected individuals in schools, health facilities and communities. Frequency distribution tables, graphs and cross tabulations were the main forms of data presentation. Results: Our results showed that there are numerous challenges that must be overcome to achieve effective control of schistosomiasis in the islands. Many people especially young men are constantly on the move from island to island in search for richer fishing grounds and such groups are commonly known to miss treatment by mass chemotherapy. Unfortunately case management in health facilities is very poor; health facilities are few and understaffed mainly with unskilled personnel who are overburdened by other illnesses such as malaria and HIV and the supply of praziquantel in health facilities is inadequate. Furthermore, sanitation is appalling, no clean water and community knowledge about schistosomiasis is low even among biomedical staff. Conclusion: Rather than elimination, our results indicate that the programme should continue to target morbidity control beyond the 2020s until preventive measures have been instituted. The government should provide adequate trained health workers and stock praziquantel in all island health facilities. © 2014 Kabatereine et al.; licensee BioMed Central.

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