An assessment of the readiness for introduction of the HPV vaccine in Uganda.

Formative research assessing human papillomavirus (HPV) vaccine readiness in Uganda was conducted in 2007. The objective was to generate evidence for government decision-making and operational planning for HPV vaccine introduction. Qualitative research methods with children, parents, teachers, community leaders, health workers, technical experts and political leaders were used to capture understanding of socio-cultural, health system and policy environments. We found low levels of knowledge about cervical cancer and HPV. Vaccination and its benefits were well-understood; respondents were positive about HPV vaccination. Health systems were deemed adequate for HPV vaccine delivery. Schools were identified as a vaccination venue, given high attendance by girls aged 10-12 years. Communication and advocacy strategies to foster acceptance should provide information on cervical cancer, HPV vaccine safety, and side effects. Policymakers requested further detail on costs. Introduction of HPV vaccine could be integrated into existing reproductive health and immunization policies.

Self-treatment by Kenyan and Ugandan schoolchildren and the need for school-based education.

Studies on Kenyan and Ugandan primary schoolchildren's knowledge of medicines and self-treatment practices show that children aged between 10 and 18 years have a broad knowledge of herbal and biomedical remedies and that they use them frequently, often without adults' involvement. They use pharmaceuticals, including prescription-only drugs, but lack knowledge about indications and dosages. There is a gap between the children's life worlds and the school health education as it is presently designed and taught in Kenya and Uganda. It limits itself to disease prevention and health promotion, and does not teach treatment or medicine-use. Self-treatment based on insufficient knowledge poses a threat to children's health and to the health of the wider community. Therefore, education on the critical and appropriate use of medicines needs to be developed and tested for possible use in Kenya, Uganda and other countries in which home-treatment is common. The proposed education on medicines should go beyond providing information on accurate dosage and indication: it should create critical awareness with regard to medicine-use, enabling children to use them appropriately and cautiously. Kenyan and Ugandan primary schoolchildren are active agents within pluralistic medical fields. By taking the children seriously as competent health care agents, the dangers of self-treatment could be reduced, and the potential of children could be guided to fruitful use. Educational interventions cannot solve the problems of self-treatment, which are related to the wider social and economic context, but they could contribute to increased awareness as a necessary condition for change.

Postnatal growth of abandoned preterm babies.

Eighteen abandoned low birth weight infants matched for sex and gestational age with infants who had mothers were followed up till discharge or death. Anthropometric measurements were taken on recruitment and then weekly. Initially all infants were on breast milk. For the abandoned ones, milk was obtained from other mothers. Results show that the abandoned infants were on breast milk until they attained a mean weight of 1960gm. This coincided with a postnatal age of 6 weeks. For the rest of the period they were on artificial feed. Mean birth weight was 1403 +/- 302 and 1337 +/- 204 for cases and controls respectively while the mean gestation was 30 weeks. Anthropometric measurements were similar at the beginning of the study and both groups regained birth weight at 2 weeks. Thereafter the rate of weight gain of 16gm per day for the cases was significantly lower than that of 22gm per day for the controls. Similarly midarm circumference increases were much lower in the cases than in controls (0.2cm versus 0.4 per week). There were however no significant differences in length and head circumference increases. A significant number of cases (94.4%) had one or more episodes of serious infection and 38.9% died. None of the control infants died and only 10.5% had serious infection.

Economic Survival Strategies of Health Workers in Uganda

"Background: Uganda has since independence followed a policy in which government health services are provided free of charge at the point of use. During the early 90's; in response to new health financing initiatives which have been advocated globally; the government has been considering the idea of introducing user charges as a means of cost recovery. However; the discussion of ""free versus charged"" health services ignored the existing widespread practice of unofficial charging for government health services. In line with the decrease of the purchasing power of civil servants' salaries; civil servants are forced to embark on salary supplementing activities which may or may not be carried out within their official duties. These activities including unofficial charging are often referred to as economic survival strategies.Objectives: The general objectives of this study was to provide policy makers with information on the range and nature of health workers' survival strategies; how they are chosen and what effect they have on patient care. The specific objectives were: - to describe the range and nature of economic activities used by government health workers to supplement their salaries; - to identify and describe those economic activities which pass the cost of this supplement directly or indirectly on to patients; - to describe the determinants of those economic activities that are likely to result in passing survival costs on to patients."