Parasite-based malaria diagnosis: Are Health Systems in Uganda equipped enough to implement the policy?
<p>Abstract</p> <p>Background</p> <p>Malaria case management is a key strategy for malaria control. Effective coverage of parasite-based malaria diagnosis (PMD) remains limited in malaria endemic countries. This study assessed the health system's capacity to absorb...
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| Format: | Article |
| Language: | English |
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BMC
2012-08-01
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| Series: | BMC Public Health |
| Online Access: | http://www.biomedcentral.com/1471-2458/12/695 |
| _version_ | 1818641386211115008 |
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| author | Kyabayinze Daniel J Achan Jane Nakanjako Damalie Mpeka Betty Mawejje Henry Mugizi Rukaaka Kalyango Joan N D’Alessandro Umberto Talisuna Ambrose Jean-Pierre Van geertruyden |
| author_facet | Kyabayinze Daniel J Achan Jane Nakanjako Damalie Mpeka Betty Mawejje Henry Mugizi Rukaaka Kalyango Joan N D’Alessandro Umberto Talisuna Ambrose Jean-Pierre Van geertruyden |
| author_sort | Kyabayinze Daniel J |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>Malaria case management is a key strategy for malaria control. Effective coverage of parasite-based malaria diagnosis (PMD) remains limited in malaria endemic countries. This study assessed the health system's capacity to absorb PMD at primary health care facilities in Uganda.</p> <p>Methods</p> <p>In a cross sectional survey, using multi-stage cluster sampling, lower level health facilities (LLHF) in 11 districts in Uganda were assessed for 1) tools, 2) skills, 3) staff and infrastructure, and 4) structures, systems and roles necessary for the implementing of PMD.</p> <p>Results</p> <p>Tools for PMD (microscopy and/or RDTs) were available at 30 (24%) of the 125 LLHF. All LLHF had patient registers and 15% had functional in-patient facilities. Three months’ long stock-out periods were reported for oral and parenteral quinine at 39% and 47% of LLHF respectively. Out of 131 health workers interviewed, 86 (66%) were nursing assistants; 56 (43%) had received on-job training on malaria case management and 47 (36%) had adequate knowledge in malaria case management. Overall, only 18% (131/730) Ministry of Health approved staff positions were filled by qualified personnel and 12% were recruited or transferred within six months preceding the survey. Of 186 patients that received referrals from LLHF, 130(70%) had received pre-referral anti-malarial drugs, none received pre-referral rectal artesunate and 35% had been referred due to poor response to antimalarial drugs.</p> <p>Conclusion</p> <p>Primary health care facilities had inadequate human and infrastructural capacity to effectively implement universal parasite-based malaria diagnosis. The priority capacity building needs identified were: 1) recruitment and retention of qualified staff, 2) comprehensive training of health workers in fever management, 3) malaria diagnosis quality control systems and 4) strengthening of supply chain, stock management and referral systems.</p> |
| first_indexed | 2024-12-16T23:26:20Z |
| format | Article |
| id | doaj.art-cc1cd2392f9d444ea8b213c2977220d3 |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-12-16T23:26:20Z |
| publishDate | 2012-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-cc1cd2392f9d444ea8b213c2977220d32022-12-21T22:12:00ZengBMCBMC Public Health1471-24582012-08-0112169510.1186/1471-2458-12-695Parasite-based malaria diagnosis: Are Health Systems in Uganda equipped enough to implement the policy?Kyabayinze Daniel JAchan JaneNakanjako DamalieMpeka BettyMawejje HenryMugizi RukaakaKalyango Joan ND’Alessandro UmbertoTalisuna AmbroseJean-Pierre Van geertruyden<p>Abstract</p> <p>Background</p> <p>Malaria case management is a key strategy for malaria control. Effective coverage of parasite-based malaria diagnosis (PMD) remains limited in malaria endemic countries. This study assessed the health system's capacity to absorb PMD at primary health care facilities in Uganda.</p> <p>Methods</p> <p>In a cross sectional survey, using multi-stage cluster sampling, lower level health facilities (LLHF) in 11 districts in Uganda were assessed for 1) tools, 2) skills, 3) staff and infrastructure, and 4) structures, systems and roles necessary for the implementing of PMD.</p> <p>Results</p> <p>Tools for PMD (microscopy and/or RDTs) were available at 30 (24%) of the 125 LLHF. All LLHF had patient registers and 15% had functional in-patient facilities. Three months’ long stock-out periods were reported for oral and parenteral quinine at 39% and 47% of LLHF respectively. Out of 131 health workers interviewed, 86 (66%) were nursing assistants; 56 (43%) had received on-job training on malaria case management and 47 (36%) had adequate knowledge in malaria case management. Overall, only 18% (131/730) Ministry of Health approved staff positions were filled by qualified personnel and 12% were recruited or transferred within six months preceding the survey. Of 186 patients that received referrals from LLHF, 130(70%) had received pre-referral anti-malarial drugs, none received pre-referral rectal artesunate and 35% had been referred due to poor response to antimalarial drugs.</p> <p>Conclusion</p> <p>Primary health care facilities had inadequate human and infrastructural capacity to effectively implement universal parasite-based malaria diagnosis. The priority capacity building needs identified were: 1) recruitment and retention of qualified staff, 2) comprehensive training of health workers in fever management, 3) malaria diagnosis quality control systems and 4) strengthening of supply chain, stock management and referral systems.</p>http://www.biomedcentral.com/1471-2458/12/695 |
| spellingShingle | Kyabayinze Daniel J Achan Jane Nakanjako Damalie Mpeka Betty Mawejje Henry Mugizi Rukaaka Kalyango Joan N D’Alessandro Umberto Talisuna Ambrose Jean-Pierre Van geertruyden Parasite-based malaria diagnosis: Are Health Systems in Uganda equipped enough to implement the policy? BMC Public Health |
| title | Parasite-based malaria diagnosis: Are Health Systems in Uganda equipped enough to implement the policy? |
| title_full | Parasite-based malaria diagnosis: Are Health Systems in Uganda equipped enough to implement the policy? |
| title_fullStr | Parasite-based malaria diagnosis: Are Health Systems in Uganda equipped enough to implement the policy? |
| title_full_unstemmed | Parasite-based malaria diagnosis: Are Health Systems in Uganda equipped enough to implement the policy? |
| title_short | Parasite-based malaria diagnosis: Are Health Systems in Uganda equipped enough to implement the policy? |
| title_sort | parasite based malaria diagnosis are health systems in uganda equipped enough to implement the policy |
| url | http://www.biomedcentral.com/1471-2458/12/695 |
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