ABSTRACT
The Objectives of this study are: To determine the impact of user fees on the utilization of health services in a community-based cost-sharing scheme in Kabarole District; Western Uganda. Methods: Of the 38 government health units that had introduced user-fee financing schemes; 11 were included in the study. Outpatient utilization was assessed as the median number of visits per month before and after cost sharing began. Findings: After the introduction of cost sharing; overall utilization of general outpatient services; assessed by combining the data from all the participating units; dropped by 21.3. Utilization increased; however; in facilities located in remote areas; while it decreased in those located in urban or semi-urban areas. The increased utilization in remote facilities was considered to be largely attributable to health workers' incentives payments derived from cost-sharing revenues. Conclusions: Incentive payments led the health workers to offer improved services. Other factors may also have been influential; such as an improved drug supply to health facilities and increased public identification with community projects in remote areas
Subject(s)
Health ServicesABSTRACT
In an in vivo study of antimalarial sensitivity in kabarole district; Western Uganda; 82of asymptomatic malarial infections and 86of symptomatic infections were chloroquine sensitive. Of persons with symptomatic malaria; 88were sensitive to sulfadoxine-pyrimethamine (Fansidar). Amodiaquine cleared parasites in all persons in whom it was used. Over the course of the past five years; there appears to be no substantial increase in the extent of chloroquine resistance in Western Uganda. Source: Trop.Geogr.Med. 1994; 46(6):364-5
Subject(s)
Chloroquine , Malaria , PlasmodiumABSTRACT
"The policy makers of Ministry of Health went [June 1993] to Washington to discuss the World Development Report (WDR) entitled ""Investing in Health"". Our Minister interacted with authors of the above report and those of ""Better health in Africa"". while there; the three minsiters of Health of Kenya; Tanzania and Uganda expressed interest in applying the same concepts and methodology to their nations. Eriteria and Ethiopia also joined in the study making it a total of five countries. This study was carried out together but each country represented by a team. The article therefore contains the outline of the methodology and the result of the study. In this study; Burden of Diseases (BOD) means the number of life years lost due to each disease every year. The exercise was very useful for each country and pointed out areas which may be improved regarding sources of funding as well as improvements which may be made in expenditures of the funding."
Subject(s)
Cost of Illness , Costs and Cost Analysis , Health Policy , Health Services ResearchABSTRACT
Kasese district in Western Uganda was hit by cholera outbreak from October 1991 to December 1992. The cumulative total of admitted cases was 1685. Deaths were 105. This excludes cases in OPD and temporary treatment centres. At the moment a neighboring district of Bundibugyo has a cholera outbreak. Thirty one (31) countries in Africa are reporting cases of Cholera to WHO. This was a multilateral mode of transmission implicating contaminated river water supplies; travel to endemic areas and food borne transmission. The risk factors were unsafe river water (RR 2.55); travel to a naighboring country with endemic cholera within 2 weeks before onset of signs symptoms (RR2) compared to controls. A steady diet of fish and Bundu (local staple of cassava bread) had a higher risk than controls (RR 1.8). Drinking boiled water protected against Cholera infection (RR 0.4). Laboratory studies demonstrated that V. cholera 01 EL TOR biotype Ogawa serotype was the responsible organism. The response and management of the epidemic centred around appropriate organisation at National; District; Subcounty (S/C); communities and health units. The organisation included proper case management; health education; personal and domestic hygiene; surveillance and notification. National and district task forces with clear terms of reference were formed. A task force was also put in place at sub-county and community (RC1) level. There was collaboration with multilateral agencies namely UNICEF et WHO Training of Health Workers in Cholera Case management was organised. Support supervisors at district level was emphasised. health messages on Cholera were formulated into local languages. Communities were sensitized about cholera and its control measures in order to enlist community participation and involvement. This paper describes details of responses at various levels in order to achieve a quickened control of the epidemic in the district