Kibirige D.,St Raphael of St Francis Hospital Nsambya |
Mwebaze R.,St Raphael of St Francis Hospital Nsambya |
Mwebaze R.,Uganda Martyrs University
Journal of Diabetes and Metabolic Disorders | Year: 2013
Vitamin B12 is an essential micronutrient required for optimal hemopoetic, neuro-cognitive and cardiovascular function. Biochemical and clinical vitamin B12 deficiency has been demonstrated to be highly prevalent among patients with type 1 and type 2 diabetes mellitus. It presents with diverse clinical manifestations ranging from impaired memory, dementia, delirium, peripheral neuropathy, sub acute combined degeneration of the spinal cord, megaloblastic anemia and pancytopenia. This review article offers a current perspective on the physiological roles of vitamin B12, proposed pathophysiological mechanisms of vitamin B12 deficiency, screening for vitamin B12 deficiency and vitamin B12 supplementation among patients with diabetes mellitus. © 2013 Kibirige and Mwebaze; licensee BioMed Central Ltd.
Namaganda G.,Abt Associates |
Oketcho V.,IntraHealth International |
Maniple E.,Uganda Martyrs University |
Viadro C.,Hill International
Human Resources for Health | Year: 2015
Background: Uganda's health workforce is characterized by shortages and inequitable distribution of qualified health workers. To ascertain staffing levels, Uganda uses fixed government-approved norms determined by facility type. This approach cannot distinguish between facilities of the same type that have different staffing needs. The Workload Indicators of Staffing Need (WISN) method uses workload to determine number and type of staff required in a given facility. The national WISN assessment sought to demonstrate the limitations of the existing norms and generate evidence to influence health unit staffing and staff deployment for efficient utilization of available scarce human resources. Methods: A national WISN assessment (September 2012) used purposive sampling to select 136 public health facilities in 33/112 districts. The study examined staffing requirements for five cadres (nursing assistants, nurses, midwives, clinical officers, doctors) at health centres II (n = 59), III (n = 53) and IV (n = 13) and hospitals (n = 11). Using health management information system workload data (1 July 2010-30 June 2011), the study compared current and required staff, assessed workload pressure and evaluated the adequacy of the existing staffing norms. Results: By the WISN method, all three types of health centres had fewer nurses (42-70%) and midwives (53-67%) than required and consequently exhibited high workload pressure (30-58%) for those cadres. Health centres IV and hospitals lacked doctors (39-42%) but were adequately staffed with clinical officers. All facilities displayed overstaffing of nursing assistants. For all cadres at health centres III and IV other than nursing assistants, the fixed norms or existing staffing or both fell short of the WISN staffing requirements, with, for example, only half as many nurses and midwives as required. Conclusions: The WISN results demonstrate the inadequacies of existing staffing norms, particularly for health centres III and IV. The results provide an evidence base to reshape policy, adopt workload-based norms, review scopes of practice and target human resource investments. In the near term, the government could redistribute existing health workers to improve staffing equity in line with the WISN results. Longer term revision of staffing norms and investments to effectively reflect actual workloads and ensure provision of quality services at all levels is needed. © 2015 Namaganda et al.
Mwine J.T.,Uganda Martyrs University |
van Damme P.,Ghent University
Journal of Medicinal Plants Research | Year: 2011
Euphorbiaceae is among the large flowering plant families consisting of a wide variety of vegetative forms some of which are plants of great importance. Its classification and chemistry have of late been subjects of interest possibly because of the wide variety of chemical composition of its members, many of which are poisonous but useful. In this review, we have tried to demonstrate why Euphorbiaceae are important medicinal plants. Two important issues have come up. The worldwide distribution of the family exposes its members, to all sorts of habitats to which they must adapt, therefore inducing a large variety of chemicals (secondary substances) that are employed for survival/defense. Succulence and the CAM (crassulacean acid metabolism) pathway that characterize a good number of its members were quoted as some of the adaptations that aid colonization and survival to achieve this induction. We have also found out that medicinal properties of some of its species may be due to stress factors that characterize most habitats of the family. Varying stress factors like temperature, salinity, drought and others were seen to operate in tandem with genetic factors such as gene expression and mutation loads to bring about synthesis of a wide assemblage of secondary substances that may probably be responsible for the family's medicinal nature. It was concluded that the family is a good starting point for the search for plant-based medicines. © 2011 Academic Journals.
Sigei C.,P.O. Box 293 20203 |
Odaga J.,Uganda Martyrs University |
Mvundura M.,PATH |
Madrid Y.,PATH |
Clark A.D.,London School of Hygiene and Tropical Medicine
Vaccine | Year: 2015
Introduction: Rotavirus vaccines have the potential to prevent a substantial amount of life-threatening gastroenteritis in young African children. This paper presents the results of prospective cost-effectiveness analyses for rotavirus vaccine introduction for Kenya and Uganda. Methodology: In each country, a national consultant worked with a national technical working group to identify appropriate data and validate study results. Secondary data on demographics, disease burden, health utilization, and costs were used to populate the TRIVAC cost-effectiveness model. The baseline analysis assumed an initial vaccine price of $0.20 per dose, corresponding to Gavi, the Vaccine Alliance stipulated copay for low-income countries. The incremental cost-effectiveness of a 2-dose rotavirus vaccination schedule was evaluated for 20 successive birth cohorts from the government perspective in both countries, and from the societal perspective in Uganda. Results: Between 2014 and 2033, rotavirus vaccination can avert approximately 60,935 and 216,454 undiscounted deaths and hospital admissions respectively in children under 5 years in Kenya. In Uganda, the respective number of undiscounted deaths and hospital admission averted is 70,236 and 329,779 between 2016 and 2035. Over the 20-year period, the discounted vaccine program costs are around US$ 80 million in Kenya and US$ 60 million in Uganda. Discounted government health service costs avoided are US$ 30 million in Kenya and US$ 10 million in Uganda (or US$ 18 million including household costs). The cost per disability-adjusted life-year (DALY) averted from a government perspective is US$ 38 in Kenya and US$ 34 in Uganda (US$ 29 from a societal perspective). Conclusions: Rotavirus vaccine introduction is highly cost-effective in both countries in a range of plausible 'what-if' scenarios. The involvement of national experts improves the quality of data used, is likely to increase acceptability of the results in decision-making, and can contribute to strengthened national capacity to undertake economic evaluations. © 2015 Elsevier Ltd.
Nalwoga M.M.,Uganda Martyrs University |
Van Dijk M.P.,Erasmus University Rotterdam
International Journal of Water | Year: 2016
In this contribution, organisational performance measurement models are reviewed to determine to what extent they can also be used as an instrument for poverty alleviation. In this paper, we explore the organisational performance models. We start with a review of general performance measurement in private and public sectors and then we focus on performance measures in the water sector. It is concluded that the performance measurement models reviewed can be applied in the water and sanitation sector as well, but it is a challenge to make them pro-poor. Copyright © 2016 Inderscience Enterprises Ltd.