Capacity to provide care for common childhood infections at low-level private health facilities in Western, Uganda
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Date
2021
Journal Title
Journal ISSN
Volume Title
Publisher
PLoS ONE
Abstract
Low-level private health facilities (LLPHFs) handle a considerable magnitude of sick children
in low-resource countries. We assessed capacity of LLPHFs to manage malaria, pneumonia,
diarrhea, and, possible severe bacterial infections (PSBIs) in under-five-year-olds.
Methods
We conducted a cross-sectional survey in 110 LLPHFs and 129 health workers in Mbarara
District, Uganda between May and December 2019. Structured questionnaires and observation
forms were used to collect data on availability of treatment guidelines, vital medicines,
diagnostics, and equipment; health worker qualifications; and knowledge of management of
common childhood infections.
Results
Amoxicillin was available in 97%, parental ampicillin and gentamicin in 77%, zinc tablets and
oral rehydration salts in >90% while artemether-lumefantrine was available in 96% of
LLPHF. About 66% of facilities stocked loperamide, a drug contraindicated in the management
of diarrhoea in children. Malaria rapid diagnostic tests and microscopes were available
in 86% of the facilities, timers/clocks in 57% but only 19% of the facilities had weighing
scales and 6% stocked oxygen. Only 4% of the LLPHF had integrated management of childhood
illness (IMCI) booklets and algorithm charts for management of common childhood illnesses.
Of the 129 health workers, 52% were certificate nurses/midwives and (26%
diploma nurses/clinical officers; 57% scored averagely for knowledge on management of
common childhood illnesses. More than a quarter (38%) of nursing assistants had low knowledge scores. No notable significant differences existed between rural and urban
LLPHFs in most parameters assessed.
Conclusion
Vital first-line medicines for treatment of common childhood illnesses were available in most
of the LLPHFs but majority lacked clinical guidelines and very few had oxygen. Majority of
health workers had low to average knowledge on management of the common childhood illnesses.
There is need for innovative knowledge raising interventions in LLPHFs including
refresher trainings, peer support supervision and provision of job aides.
Description
Keywords
Care, Childhood infections, Private health facilities, Western Uganda
Citation
Mwanga-Amumpaire J, Ndeezi G, Ka¨llander K, Obua C, Migisha R, Nkeramahame J, et al. (2021) Capacity to provide care for common childhood infections at low-level private health facilities in Western, Uganda. PLoS ONE 16(10): e0257851. https://doi.org/10.1371/journal. pone.0257851