Risk factors for diarrhoea and upper respiratory tract infections among children in a rural area of Uganda.

This study explored risk factors associated with diarrhoea and upper respiratory tract infections (URTIs) among children in Sembabule district, Uganda. Data were collected from 300 women with children aged less than two years using the WHO 30-cluster sampling technique. The prevalence of diarrhoea among children was 40.3%. A child not immunized (odds ratio [OR] 2.8, p < 0.001), absence of latrine in a house (OR 1.4, p < 0.03), low knowledge of mixing oral rehydration salts (OR 1.7, p < 0.01), garbage thrown anywhere around the house (OR 2.6, p < 0.001), not washing hands after using latrine (OR 1.8, p < 0.03), and not washing hands before preparing food (OR 1.4, p < 0.04) were risk factors for diarrhoea. The prevalence of URTIs among children was 37.4%. A child not immunized (OR 2.4, p < 0.001), children aged 6-11 months (OR 2.1, p < 0.03), and previous episode of diarrhoea (OR 2.5, p < 0.001) were risk factors for URTIs. The results showed that low immunization status was an important risk factor for diarrhoea and URTIs among children in the study district of Uganda. For 75% of the children, care for fever was obtained from drug shops, while 9.2% were taken to health units. This is in contrast to diarrhoea cases where 49.5% of children were taken to health units for care. To reduce the burden of disease among children in this district, an integrated package of immunization services and other childcare programmes need to be implemented in addition to improved personal and environmental hygiene. There is also a need to design well-focused health-education messages to improve treatment-seeking behaviour for childhood diseases.

Risk factors associated with maternal deaths in health units in Uganda

This study was conducted to assess the magnitude of maternal deaths in health units in Uganda; and the risk factors associated with such death. A retrospective study of maternal deaths in 20 hospitals and 54 randomly selected health centres was conducted in 12 randomly selected districts of Uganda. The reference period for documenting maternal deaths was September 1992 to September 1993. The International Classification of Diseases 10 was used to define a maternal death. Data on maternal deaths and associated risk factors risk factors was obtained from admission and patient case notes.SPSS/PC statistical package was used to carry out advanced statistical analysis. Long linear analysis was used to rank risk factors for maternal mortality ratio of 557 per 100;000 live births. Three hundred and sixty (86.1) mothers died within one hour of admissio. The risk factors identifed were inadequate antibiotic supply; intravenous drug fluids and blood for transfusion in health units; non-use of family planning; use of traditional medicine; mothers aged 15-19 and 30-50 years. Others included those who had a history of two or more abortions and stillbirths; parity of five and above; and living within a distance of more than 10km to the nearest health unit. We conclude that the focus on the risk factors for maternal deaths have policy implications

The Structure of the Ministry of Health: Is There Room for Democracy and Motivation?

This paper presents three arguments on the macro-structure of the Ministry of Health (MoH) headquarters. The main argument is to what extent can a structure with no internal mobility motivate the personnel who work in such a structure. The second argument is whether the MoH management can marshal maximum cooperation of its personnel to achieve maximum performance. The third argument is whether internal democracy is possible within the macro-structure. The paper provides alternative ways of motivating personnel within the structure and proposes new initiatives that should be taken into consideration by the management. In this paper; the term management refers to the Top management in the Ministry of Health structure. The term personnel refers to the technical people within the structure; particularly Public Health specialists. Motivation is defined in this paper as a person's drive to work because that person wants to do so. The paper is divided into three parts. First; it presents theoretical models on movitivation in organisations. Second; it presents the macro- structure of the Ministry of Health and third; it provides alternative models of motivating personnel within the structure

UDSH 2000: Why are Health Indicators Declining?

Indicators are measures of performance. They are used quite often by policy makers and managers to measure progress and the impact of programmes. They are also used to measure overall performance in the health and other social sectors. For example; one of the indicators used to measure the impact of health and other social programmes is the infant mortality rate. This indicator is believed to be sensitive to changes in the health; social; economic and environmental sectors that it can be used as a summary measure of performance in those sectors. This paper reviews the preliminary findings on indicators from the Uganda Demographic and Health Survey (UDHS) 2000/01. A computation of what these indicators translate to is presented. The details on the formulae; equations and data requirements used to calculate the indicators is beyond the scope of this paper. This presentation aims at providing insight into what the UDHS 2000 indicators imply; and what they translate to in order to assist approariate planning and advocacy for resource allocation