Browsing by Author "Bataringaya, Juliet"

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    Capacity Building in the Management of Severe Acute Malnutrition: experience from Uganda
    (International Journal of Food, Nutrition and Public Health, 2017) Turyashemererwa, Florence M.; Bekele, Hana; Bataringaya, Juliet; Wondimagegnehu, Alemu
    To share experiences on the capacity building of health workers in the treatment protocols for the management of children with severe acute malnutrition (SAM) in Uganda. With financial support from the Global Aff airs Canada, the World Health Organization provided Technical expertise to update Uganda treatment guidelines and training materials for SAM in line with global guidance. In addition, the health workers received training and mentorship on the use of the up dated guidelines. This was followed by support supervision to assess the case fatality rate from SAM, and understand the issues experienced in improving the care for SAM children. A total of 153 health workers were trained in the training of trainers, and 15 in training of facilitators’ workshops. The average pre- and post-test scores were 60% and 85%, respectively, for the training of facilitators and 56% and68% respectively, for the training of trainers. A total of 521 health workers were mentored at their respective health care facilities. The average case fatality rate was 16.5% and 0.5% at two major hospitals. Effective management of SAM centred around the technical capacity, structure and processes involved. The results highlight the need for commitment to reduce deaths from children with SAM. An approach that looks beyond training and considers all components of the health care system is important.
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    A Critique of the Uganda District League Table using a Normative Health System Performance Assessment Framework
    (BMC health services research, 2018) Tashobya, Christine Kirunga; Ssengooba, Freddie; Nabyonga-Orem, Juliet; Bataringaya, Juliet; Marchal, Bruno; Criel, Bart
    In 2003 the Uganda Ministry of Health (MoH) introduced the District League Table (DLT) to track district performance. This review of the DLT is intended to add to the evidence base on Health Systems Performance Assessment (HSPA) globally, with emphasis on Low and Middle Income Countries (LMICs), and provide recommendations for adjustments to the current Ugandan reality.A normative HSPA framework was used to inform the development of a Key Informant Interview (KII) tool. Thirty Key Informants were interviewed, purposively selected from the Ugandan health system on the basis of having developed or used the DLT. KII data and information from published and grey literature on the Uganda health system was analyzed using deductive analysis.
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    A critique of the Uganda district league table using a normative health system performance assessment framework
    (BMC health services research, 2018) KirungaTashobya, Christine; Ssengooba, Freddie; Nabyonga-Orem, Juliet; Bataringaya, Juliet; Macq, Jean; Marchal, Bruno; Musila, Timothy; Criel, Bart
    In 2003 the Uganda Ministry of Health (MoH) introduced the District League Table (DLT) to track district performance. This review of the DLT is intended to add to the evidence base on Health Systems Performance Assessment (HSPA) globally, with emphasis on Low and Middle Income Countries (LMICs), and provide recommendations for adjustments to the current Ugandan reality. Methods: A normative HSPA framework was used to inform the development of a Key Informant Interview (KII) tool. Thirty Key Informants were interviewed, purposively selected from the Ugandan health system on the basis of having developed or used the DLT. KII data and information from published and grey literature on the Uganda health system was analyzed using deductive analysis. Results: Stakeholder involvement in the development of the DLT was limited, including MoH officials and development partners, and a few district technical managers. Uganda policy documents articulate a conceptually broad health system whereas the DLT focuses on a healthcare system. The complexity and dynamism of the Uganda health system was insufficiently acknowledged by the HSPA framework. Though DLT objectives and indicators were articulated, there was no conceptual reference model and lack of clarity on the constitutive dimensions. The DLT mechanisms for change were not explicit. The DLT compared markedly different districts and did not identify factors behind observed performance. Uganda lacks a designated insti
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    The Ugandan Health Systems Reforms: miracle or mirage?
    (2006) Yates, Rob; Tashobya, Christine Kirunga; Ssengooba, Freddie; Murindwa, Grace; Lochoro, Peter; Bataringaya, Juliet; Nazerali, Hanif; Omaswa, Francis
    Poor health indicators in the 1990s prompted the Government of Uganda and development partners to embark, at the turn of the century, on an extensive programme of health systems reforms to improve sector performance. With only a modest increase in resources, these reforms have resulted in large increases in outputs for ambulatory services. Out-patient attendances and immunisation rates have doubled. Furthermore, the growth in consumption of these services appears to be highest for the poorest socio-economic groups. However, statistics for key in-patient services, most noticeably maternity services, remain virtually unchanged. This chapter attempts to assess the significance of these changes. Is it a miracle of improved efficiency or a mirage unlikely to lead to improved health outcomes? We try to identify the key reforms within health and across government, which may be responsible for the changes in output performance. A number of supply side reforms that have have increased the availability of essential inputs are highlighted. In addition, a major demand side policy (abolishing user fees) had a significant impact on the consumption of services. We conclude that increased utilisation of ambulatory services does signify improvements in consumer welfare and therefore health sector performance. However, stagnant maternity outputs indicate that key in-patient services are still not meeting the expectations of the population. Only reliable outcome data will resolve the debate about the significance of the changes in output indicators. Further research will also be required to disentangle the relative impact of the different components of the reforms.