Browsing by Author "Onama, Virgil"

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    Health systems factors influencing maternal health services: a four-country comparison
    (Health policy, 2005) Parkhurst, Justin O.; Penn-Kekana, Loveday; Blaauw, Duane; Balabanova, Dina; Danishevski, Kirill; Rahman, Syed A.; Onama, Virgil; Ssengooba, Freddie
    It is widely understood that maternal health care relies on the entire health system. However, little empirical, country-specific, research has been done to trace out the ways in which health system elements can shape maternal health outcomes. This study seeks to redress this situation, by providing an example of how a health systems approach can benefit the understanding of maternal health services. A comparative analysis was conducted based on extensive case studies of maternal health and health systems in Bangladesh, Russia, South Africa, and Uganda. A number of cross-cutting health system characteristics affecting maternal health were identified by comparing these diverse settings. The most important common systems issues underlying maternal health care were found to be the human resource structures, the public–private mix of service provision, and the changes involved with health sector reforms. Specific country contexts can further determine many factors influencing maternal health outcomes and service performance. Systems issues were found to influence the access to and utilization of services, quality of care provided, and ultimately maternal health outcomes. This paper provides a first step in tracing out how such broad systems issues actually work to influence maternal health
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    Maternal Health Review Uganda
    (Makerere University Institute of Public Health, 2003) Ssengooba, Freddie; Neema, Stella; Mbonye, Anthony; Sentubwe, Olive; Onama, Virgil
    Uganda has a high maternal mortality ratio, typical of many countries in sub-Saharan Africa, with an estimated 505 maternal deaths per 100.000 live births. While several measures to combat the poor reproductive health performance have been put in place by the government, Maternal and Child Health programs have in the past focused more attention on child-care programs with a particularly strong emphasis on immunization. A number of studies have been undertaken in Uganda to understand the dimensions of maternal health performance and the broader reproductive rights and health issues. In many cases the available literature has been fragmented with little effort to bring it together for policy and health systems learning. The Demographic Health Surveys of 1988-1989, 1995 and 2000-2001 [1,2,3] have been a major source of information on maternal and reproductive health. The Safe Motherhood Needs Assessment of 1995/6, which was conducted in 14 districts, and is the largest recent survey of institutional capacity to deliver maternal services, provides another source of baseline information on maternal health. Several small studies have been undertaken that have important bearings on maternal health and reproductive health in general.
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    The Potential of the Private Sector to Improve Health Outcomes in Uganda
    (Makerere University Institute of Public Health, 2006) Konde-Lule, Joseph; Okuonzi, Sam; Matsiko, Charles; Mukanga, David; Onama, Virgil; Gitta, Sheba Nakacubo
    In Uganda, as in many other developing countries, the rural poor shoulder a large share of the disease burden, but the mix and roles of the health providers accessible to local communities has not been fully documented.