Browsing by Author "Banoba, Paul"
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Item Changing from the “Pull” to the “Push” System of Distributing Essential Medicines and Health Supplies in Uganda: Implications for Efficient Allocation of Medicines and Meeting the Localized Needs of Health Facilities(Global Health Governance, 2013) Bukuluki, Paul; Byansi, Peter K.; Sengendo, John; Ddumba, Nyanzi I.; Banoba, Paul; Kaawa-Mafigiri, DavidUganda has undergone several reforms in governance of the health sector. One of the profound reforms has been the radical shift in management of medicines from the “pull” approach—health facility staff participated in determining the medicines needed, to the “push” approach—the distribution of a standardized kit of essential medicine to health facilities irrespective of the disease burden and patient population. This paper is based on multi-site, mixed method cross-sectional study on governance in the health sector commissioned by Transparency International. It revealed that this shift affected delivery of essential medicines for rural and hard-to-reach frontline health facilities. Although there were indications that centralization had minimized inefficiency due to over invoicing, abuse of medicine funds and re-allocating funds meant for medicines to other recurrent items, it led to the supplying of large quantities of medicines that are not aligned to the disease burden and needs of some health facilities.Item Protecting the Next Generation in Uganda(Guttmacher Institute., 2008) Darabi, Leila; Bankole, Akinrinola; Serumaga, Kalundi; Neema, Stella; Kibombo, Richard; Ahmed, F. Humera; Banoba, PaulAs young people grow into adolescence and young adulthood, most will become sexually active and thus be exposed to the dual risks of unintended pregnancy and sexually transmitted infections (STIs), most importantly HIV. Although Uganda’s multi pronged HIV prevention program—consisting of direct programmatic efforts to promote abstinence, monogamy and condom use, as well as a wide range of other strate gies to fight stigma, such as outreach to religious leaders—successfully contributed to a drop in HIV preva lence in the 1990s, that decline may have reached a plateau. Key to Uganda’s continued success in reducing HIV/AIDS, as well as unwanted pregnancy and unsafe abortion, is a commitment to focusing on young people, who dominate the country’s population. This, however, is no simple task. Those committed to protecting the next generation of Ugandans must recognize the diversity and varying needs of adolescents. For all adolescents, one thing is certain: Any program or policy aimed at protecing the sexual and reproductive health of youth will be more successful if it reaches them at the appropriate time,in some cases before they become sexually active.