Browsing by Author "Whyte, Susan Reynolds"

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    The availability of drugs: what does it mean in Ugandan primary care
    (Health Policy, 2003) Jitta, Jessica; Whyte, Susan Reynolds; Nshakira, Nathan
    Availability of drugs is often considered the most important element in quality of health care in rural African settings. Using material collected through mainly qualitative methods, this article examines drug availability in six primary health care units in southeastern Uganda. Emphasis is on the differing perspectives of three categories of actors: health planners/managers; health workers; and users of health services. The main concern is the availability of choroquine and penicillin, especially injectable forms, and the needles and syringes for administering them. Health sector reforms have changed the conditions for managing, supplying, and using drugs through decentralization, user fees, and privatization. Patients were dissaatisfied when they were not able to obtain all drugs prescribeddd at the health unit. Government health units both compete with, and use, local commercial sources of drugs. They need to attract patients and, with user fees, they are more able to supplement the drug kit supplies provided through the Ministry of Health. There is a need to revise policy in light of the new situation. Dialogue and realism are needed in order to create policies that respect both good medical treatment standards and the concerns of frontline workers and their patients. The exercise of rethinking the meaning of drug availability in primary health care calls for methodologies examining the chenging context of health care and the positions of different categories of actors, at national and district setting, to appreciate gaps existing between drug policy and practice.
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    The Visibility Of Non-Communicable Diseases In Northern Uganda
    (African Health Sciences, 2015) Whyte, Susan Reynolds; Park, Sung-Joon; Odong, George; Ojara, Moris; Lamwaka, Alice
    WHO and Uganda’s Ministry of Health emphasize the need to address the growing burden of non-communicable diseases (NCDs). Treatment for these conditions is urgent in northern Uganda where war has negatively affected both health and the public health care system.We aimed to explore the recognized presence of selected chronic conditions in the out-patient population and to relate this ‘visibility’ to the ability of health units to diagnose and treat them.At six health facilities we reviewed patient registers for one month to determine the frequency of hypertension, diabetes, depression, and post traumatic stress disorder (PTSD). We checked the availability of diagnostic instruments and medicines, and interviewed health workers.The four conditions were rarely diagnosed in the outpatient population. Hypertension was the most common, but still constituted under 1% of diagnoses. Patterns of diagnosis were uneven, with higher frequency of particular diagnoses at some health facilities. Diagnostic equipment was not sufficient and screening was irregular. Medicine was mostly available although stockouts of some relevant drugs were reported.The four conditions are relatively invisible in the outpatient population. Greater visibility would be facilitated by regular clinic days for hypertension and diabetes, availability and regular use of diagnostic instruments, and a more reliable supply of the relevant medicines.