Browsing by Author "Omaswa, Francis"

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    Managing Ebola from rural to urban slum settings: experiences from Uganda
    (African health sciences, 2015) Okware, Sam I.; Omaswa, Francis; Talisuna, Ambrose; Amandua, Jacinto; Amone, Jackson; Onek, Paul; Opio, Alex; Wamala, Joseph; Lubwama, Julius; Luswa, Lukwago; Kagwa, Paul; Tylleskar, Thorkild
    Five outbreaks of ebola occurred in Uganda between 2000-2012. The outbreaks were quickly contained in rural areas. However, the Gulu outbreak in 2000 was the largest and complex due to insurgency. It invaded Gulu municipality and the slum- like camps of the internally displaced persons (IDPs). The Bundigugyo district outbreak followed but was detected late as a new virus. The subsequent outbreaks in the districts of Luwero district (2011, 2012) and Kibaale (2012) were limited to rural areas. Methods: Detailed records of the outbreak presentation, cases, and outcomes were reviewed and analyzed. Each outbreak was described and the outcomes examined for the different scenarios. Results: Early detection and action provided the best outcomes and results. The ideal scenario occurred in the Luwero outbreak during which only a single case was observed. Rural outbreaks were easier to contain. The community imposed quarantine prevented the spread of ebola following introduction into Masindi district. The outbreak was confined to the extended family of the index case and only one case developed in the general population. However, the outbreak invasion of the town slum areas escalated the spread of infection in Gulu municipality. Community mobilization and leadership was vital in supporting early case detection and isolations well as contact tracing and public education. Conclusion: Palliative care improved survival. Focusing on treatment and not just quarantine should be emphasized as it also enhanced public trust and health seeking behavior.
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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.