24 results on '"Bua, John"'
Search Results
2. One Day in the Life of Western High School.
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Bua, John and Jackson, Nancy
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Library media staff at Western High School (Fort Lauderdale, Florida) established a library media center without walls and an information hub without limits. This article describes the planning, funding, wiring, equipping, programming, managing, and benefits of the $624,500 network. (PEN)
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- 1998
3. Increasing access to institutional deliveries using demand and supply side incentives: early results from a quasi-experimental study
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Serwadda David, Nalwadda Gorette, Mutebi Aloysius, Bua John, Rutebemberwa Elizeus, Okui Olico, Kiwanuka Noah, Makumbi Fred, Rahman M, Waiswa Peter, Ekirapa-Kiracho Elizabeth, Pariyo George W, and Peters David H
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Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background Geographical inaccessibility, lack of transport, and financial burdens are some of the demand side constraints to maternal health services in Uganda, while supply side problems include poor quality services related to unmotivated health workers and inadequate supplies. Most public health interventions in Uganda have addressed only selected supply side issues, and universities have focused their efforts on providing maternal services at tertiary hospitals. To demonstrate how reforms at Makerere University College of Health Sciences (MakCHS) can lead to making systemic changes that can improve maternal health services, a demand and supply side strategy was developed by working with local communities and national stakeholders. Methods This quasi-experimental trial is conducted in two districts in Eastern Uganda. The supply side component includes health worker refresher training and additions of minimal drugs and supplies, whereas the demand side component involves vouchers given to pregnant women for motorcycle transport and the payment to service providers for antenatal, delivery, and postnatal care. The trial is ongoing, but early analysis from routine health information systems on the number of services used is presented. Results Motorcyclists in the community organized themselves to accept vouchers in exchange for transport for antenatal care, deliveries and postnatal care, and have become actively involved in ensuring that women obtain care. Increases in antenatal, delivery, and postnatal care were demonstrated, with the number of safe deliveries in the intervention area immediately jumping from Conclusions Transport and service vouchers appear to be a viable strategy for rapidly increasing maternal care. MakCHS can design strategies together with stakeholders using a learning-by-doing approach to take advantage of community resources.
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- 2011
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4. One day in the life of Western High School: our goal was to establish a library media center
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Jackson, Nancy and Bua, John
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Multimedia technology -- Usage ,Computers -- Usage ,School libraries -- Usage ,Education -- Usage ,Computers ,Education ,Multimedia technology ,Software/hardware leasing ,Usage - Abstract
by Nancy Jackson and John Bua, Library Media Specialists Western High School Fort Lauderdale, Florida It's 7:30 in the evening, and the telephone rings at Bill's home. It is a [...]
- Published
- 1998
5. Balancing the cost of leaving with the cost of living: drivers of long-term retention of health workers : an explorative study in three rural districts in Eastern Uganda
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Kiwanuka, Suzanne Namusoke, Akulume, Martha, Tetui, Moses, Kananura, Rornald Muhumuza, Bua, John, Ekirapa-Kiracho, Elizabeth, Kiwanuka, Suzanne Namusoke, Akulume, Martha, Tetui, Moses, Kananura, Rornald Muhumuza, Bua, John, and Ekirapa-Kiracho, Elizabeth
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Background: Health worker retention in rural and underserved areas remains a persisting problem in many low and middle income countries, and this directly affects the quality of health services offered. Objective: This paper explores the drivers of long-term retention and describes health worker coping mechanisms in rural Uganda. Methods: A descriptive qualitative study explored the factors that motivated health workers to stay, in three rural districts of Uganda: Kamuli, Pallisa, and Kibuku. In-depth interviews conducted among health workers who have been retained for at least 10 years explored factors motivating the health workers to stay within the district, opportunities, and the benefits of staying. Results: Twenty-one health workers participated. Ten of them male and 11 female with the age range of 33-51 years. The mean duration of stay among the participants was 13, 15, and 26 years for Kamuli, Kibuku, and Pallisa respectively. Long-term retention was related to personal factors, such as having family ties, community ties, and opportunities to invest. The decentralization policy and pension benefits also kept workers in place. Opportunities for promotion or leadership motivated long stay only if they came with financial benefits. Workload reportedly increased over the years, but staffing and emoluments had not increased. Multiple job, family support, and community support helped health workers cope with the costs of living, and holding a secure pensionable government job was valued more highly than seeking uncertain job opportunities elsewhere. Conclusion: The interplay between the costs of leaving and the benefit of staying is demonstrated. Family proximity, community ties, job security, and pension enhance staying, while higher costs of living and an unpredictable employment market make leaving risky. Health workers should be able to access investment opportunities in order to cope with inadequate remuneration. Promotions and leadership opportunities only m, Supplement: 4Special Issue: MANIFEST (Maternal and Neonatal Implementation for Equitable Systems Study)
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- 2017
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6. Maternal and neonatal implementation for equitable systems : a study design paper
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Ekirapa-Kiracho, Elizabeth, Tetui, Moses, Bua, John, Kananura, Rornald Muhumuza, Waiswa, Peter, Makumbi, Fred, Atuyambe, Lynn, Ajeani, Judith, George, Asha, Mutebi, Aloysuis, Kakaire, Ayub, Namazzi, Gertrude, Paina, Ligia, Kiwanuka, Suzanne Namusoke, Ekirapa-Kiracho, Elizabeth, Tetui, Moses, Bua, John, Kananura, Rornald Muhumuza, Waiswa, Peter, Makumbi, Fred, Atuyambe, Lynn, Ajeani, Judith, George, Asha, Mutebi, Aloysuis, Kakaire, Ayub, Namazzi, Gertrude, Paina, Ligia, and Kiwanuka, Suzanne Namusoke
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Background: Evidence on effective ways of improving maternal and neonatal health outcomes is widely available. The challenge that most low-income countries grapple with is implementation at scale and sustainability. Objectives: The study aimed at improving access to quality maternal and neonatal health services in a sustainable manner by using a participatory action research approach. Methods: The study consisted of a quasi-experimental design, with a participatory action research approach to implementation in three rural districts (Pallisa, Kibuku and Kamuli) in Eastern Uganda. The intervention had two main components; namely, community empowerment for comprehensive birth preparedness, and health provider and management capacity-building. We collected data using both quantitative and qualitative methods using household and facility-level structured surveys, record reviews, key informant interviews and focus group discussions. We purposively selected the participants for the qualitative data collection, while for the surveys we interviewed all eligible participants in the sampled households and health facilities. Descriptive statistics were used to describe the data, while the difference in difference analysis was used to measure the effect of the intervention. Qualitative data were analysed using thematic analysis. Conclusions: This study was implemented to generate evidence on how to increase access to quality maternal and newborn health services in a sustainable manner using a multisectoral participatory approach., Supplement: 4Special Issue: MANIFEST (Maternal and Neonatal Implementation for Equitable Systems Study)
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- 2017
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7. Effect of a participatory multisectoral maternal and newborn intervention on birth preparedness and knowledge of maternal and newborn danger signs among women in Eastern Uganda : a quasi-experiment study
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Kananura, Rornald Muhumuza, Tetui, Moses, Bua, John, Ekirapa-Kiracho, Elizabeth, Mutebi, Aloysius, Namazzi, Gertrude, Kiwanuka, Suzanne Namusoke, Waiswa, Peter, Kananura, Rornald Muhumuza, Tetui, Moses, Bua, John, Ekirapa-Kiracho, Elizabeth, Mutebi, Aloysius, Namazzi, Gertrude, Kiwanuka, Suzanne Namusoke, and Waiswa, Peter
- Abstract
Background: Knowledge of obstetric danger signs and adequate birth preparedness (BP) are critical for improving maternal services utilization. Objectives: This study assessed the effect of a participatory multi-sectoral maternal and newborn intervention on BP and knowledge of obstetric danger signs among women in Eastern Uganda. Methods: The Maternal and Neonatal Implementation for Equitable Systems (MANIFEST) study was implemented in three districts from 2013 to 2015 using a quasi-experimental pre-post comparison design. Data were collected from women who delivered in the last 12 months. Difference-in-differences (DiD) and generalized linear modelling analysis were used to assess the effect of the intervention on BP practices and knowledge of obstetric danger signs. Results: The overall BP practices increased after the intervention (DiD = 5, p < 0.05). The increase was significant in both intervention and comparison areas (7-39% vs. 7-36%, respectively), with a slightly higher increase in the intervention area. Individual savings, group savings, and identification of a transporter increased in both intervention and comparison area (7-69% vs. 10-64%, 0-11% vs. 0-5%, and 9-14% vs. 9-13%, respectively). The intervention significantly increased the knowledge of at least three obstetric danger signs (DiD = 31%) and knowledge of at least two newborn danger signs (DiD = 21%). Having knowledge of at least three BP components and attending community dialogue meetings increased the odds of BP practices and obstetric danger signs' knowledge, respectively. Village health teams' home visits, intervention area residence, and being in the 25+ age group increased the odds of both BP practices and obstetric danger signs' knowledge. Conclusions: The intervention resulted in a modest increase in BP practices and knowledge of obstetric danger signs. Multiple strategies targeting women, in particular the adolescent group, are needed to promote behavior change for improved BP and kno, Supplement: 4Special Issue: MANIFEST (Maternal and Neonatal Implementation for Equitable Systems Study)
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- 2017
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8. Characteristics of community savings groups in rural Eastern Uganda : opportunities for improving access to maternal health services
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Mutebi, Aloysius, Kananura, Rornald Muhumuza, Ekirapa-Kiracho, Elizabeth, Bua, John, Kiwanuka, Suzanne Namusoke, Nammazi, Gertrude, Paina, Ligia, Tetui, Moses, Mutebi, Aloysius, Kananura, Rornald Muhumuza, Ekirapa-Kiracho, Elizabeth, Bua, John, Kiwanuka, Suzanne Namusoke, Nammazi, Gertrude, Paina, Ligia, and Tetui, Moses
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Background: Rural populations in Uganda have limited access to formal financial Institutions, but a growing majority belong to saving groups. These saving groups could have the potential to improve household income and access to health services. Objective: To understand organizational characteristics, benefits and challenges, of savings groups in rural Uganda. Methods: This was a cross-sectional descriptive study that employed both quantitative and qualitative data collection techniques. Data on the characteristics of community-based savings groups (CBSGs) were collected from 247 CBSG leaders in the districts of Kamuli, Kibukuand Pallisa using self-administered open-ended questionnaires. To triangulate the findings, we conducted in-depth interviews with seven CBSG leaders. Descriptive quantitative and content analysis for qualitative data was undertaken respectively. Results: Almost a quarter of the savings groups had 5-14 members and slightly more than half of the saving groups had 15-30 members. Ninety-three percent of the CBSGs indicated electing their management committees democratically to select the group leaders and held meetings at least once a week. Eighty-nine percent of the CBSGs had used metallic boxes to keep their money, while 10% of the CBSGs kept their money using mobile money and banks, respectively. The main reasons for the formation of CBSGs were to increase household income, developing the community and saving for emergencies. The most common challenges associated with CBSG management included high illiteracy (35%) among the leaders, irregular attendance of meetings (22%), and lack of training on management and leadership (19%). The qualitative findings agreed with the quantitative findings and served to triangulate the main results. Conclusions: Saving groups in Uganda have the basic required structures; however, challenges exist in relation to training and management of the groups and their assets. The government and development partners should, Supplement: 4Special Issue: MANIFEST (Maternal and Neonatal Implementation for Equitable Systems Study)
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- 2017
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9. Maternal and neonatal implementation for equitable systems. A study design paper
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Ekirapa-Kiracho, Elizabeth, primary, Tetui, Moses, additional, Bua, John, additional, Muhumuza Kananura, Rornald, additional, Waiswa, Peter, additional, Makumbi, Fred, additional, Atuyambe, Lynn, additional, Ajeani, Judith, additional, George, Asha, additional, Mutebi, Aloysuis, additional, Kakaire, Ayub, additional, Namazzi, Gertrude, additional, Paina, Ligia, additional, and Namusoke Kiwanuka, Suzanne, additional
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- 2017
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10. Effect of support supervision on maternal and newborn health services and practices in Rural Eastern Uganda
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Kisakye, Angela N., primary, Muhumuza Kananura, Rornald, additional, Ekirapa-Kiracho, Elizabeth, additional, Bua, John, additional, Akulume, Martha, additional, Namazzi, Gertrude, additional, and Namusoke Kiwanuka, Suzanne, additional
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- 2017
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11. Characteristics of community savings groups in rural Eastern Uganda: opportunities for improving access to maternal health services
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Mutebi, Aloysius, primary, Muhumuza Kananura, Rornald, additional, Ekirapa-Kiracho, Elizabeth, additional, Bua, John, additional, Namusoke Kiwanuka, Suzanne, additional, Nammazi, Gertrude, additional, Paina, Ligia, additional, and Tetui, Moses, additional
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- 2017
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12. Effect of a participatory multisectoral maternal and newborn intervention on birth preparedness and knowledge of maternal and newborn danger signs among women in Eastern Uganda: a quasi-experiment study
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Muhumuza Kananura, Rornald, primary, Tetui, Moses, additional, Bua, John, additional, Ekirapa-Kiracho, Elizabeth, additional, Mutebi, Aloysius, additional, Namazzi, Gertrude, additional, Namusoke Kiwanuka, Suzanne, additional, and Waiswa, Peter, additional
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- 2017
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13. Balancing the cost of leaving with the cost of living: drivers of long-term retention of health workers: an explorative study in three rural districts in Eastern Uganda
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Namusoke Kiwanuka, Suzanne, primary, Akulume, Martha, additional, Tetui, Moses, additional, Muhumuza Kananura, Rornald, additional, Bua, John, additional, and Ekirapa-Kiracho, Elizabeth, additional
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- 2017
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14. The neonatal mortality and its determinants in rural communities of Eastern Uganda
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Kananura, Rornald M., primary, Tetui, Moses, additional, Mutebi, Aloysius, additional, Bua, John N., additional, Waiswa, Peter, additional, Kiwanuka, Suzanne N., additional, Ekirapa-Kiracho, Elizabeth, additional, and Makumbi, Fredrick, additional
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- 2016
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15. Stakeholder analysis for a maternal and newborn health project in Eastern Uganda
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Gertrude Namazzi, Okui Olico, Waiswa Peter, Kiwanuka Suzanne N, Allen Katharine A, Bua John, Ekirapa Kiracho Elizabeth, and Hyder Adnan A
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Male ,Program evaluation ,Community-Based Participatory Research ,medicine.medical_specialty ,Psychological intervention ,Transportation ,Maternal and newborn health ,Community Health Planning ,Health Services Accessibility ,Health facility ,Nursing ,Pregnancy ,Obstetrics and Gynaecology ,Health care ,Humans ,Stakeholder analysis ,Medicine ,Maternal Health Services ,Uganda ,Qualitative Research ,Health Services Needs and Demand ,business.industry ,Future health systems ,Public health ,Infant, Newborn ,Stakeholder ,Obstetrics and Gynecology ,Focus Groups ,Public relations ,Millennium Development Goals ,Eastern Uganda ,Female ,business ,Research Article - Abstract
Background: Based on the realization that Uganda is not on track to achieving Millennium Development Goals 4 and 5, Makerere University School of Public Health in collaboration with other partners proposed to conduct two community based maternal/newborn care interventions aimed at increasing access to health facility care through transport vouchers and use of community health workers to promote ideal family care practices. Prior to the implementation, a stakeholder analysis was undertaken to assess and map stakeholders’ interests, influence/power and position in relation to the interventions; their views regarding the success and sustainability; and how this research can influence policy formulation in the country. Methods: A stakeholder analysis was carried out in March 2011 at national level and in four districts of Eastern Uganda where the proposed interventions would be conducted. At the national level, four key informant interviews were conducted with the ministry of health representative, Member of Parliament, and development partners. District health team members were interviewed and also engaged in a workshop; and at community level, twelve focus group discussions were conducted among women, men and motorcycle transporters. Results: This analysis revealed that district and community level stakeholders were high level supporters of the proposed interventions but not drivers. At community level the mothers, their spouses and transporters were of low influence due to the limited funds they possessed. National level and district stakeholders believed that the intervention is costly and cannot be affordably scaled up. They advised the study team to mobilize and sensitize the communities to contribute financially from the start in order to enhance sustainability beyond the study period. Stakeholders believed that the proposed interventions will influence policy through modeling on how to improve the quality of maternal/newborn health services, male involvement, and improved accessibility of services. Conclusion: Most of the stakeholders interviewed were supporters of the proposed maternal and newborn care intervention because of the positive benefits of the intervention. The analysis highlighted stakeholder concerns that will be included in the final project design and that could also be useful in countries of similar setting that are planning to set up programmes geared at increasing access to maternal and new born interventions. Key among these concerns was the need to use both human and financial resources that are locally available in the community, to address supply side barriers that influence access to maternal and child healthcare. Research to policy translation, therefore, will require mutual trust, continued dialogue and engagement of the researchers, implementers and policy makers to enable scale up.
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- 2013
16. Quality of Antenatal care services in eastern Uganda: implications for interventions
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Tetui, Moses, Ekirapa, Elizabeth Kiracho, Bua, John, and Mutebi, Aloysius
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Introduction More efforts need to be directed to improving the quality of maternal health in developing countries if we are to keep on track with meeting the fifth millennium development goal. The World Health Organization says developing countries account for over 90% of maternal deaths of which three fifths occur in Sub-Saharan African countries like Uganda. Abortion, obstetric complications such as hemorrhage, dystocia, eclampsia, and sepsis are major causes of maternal deaths here. Good quality Antenatal Care (ANC) provides opportunity to detect and respond to risky maternal conditions. This study assessed quality of ANC services in eastern Uganda with a goal of benchmarking implications for interventions. Methods Data was collected from 15 health facilities in Eastern Uganda to establish capacity of delivering ANC services. Observation checklists were used to assess structural components and completeness of the ANC consultation process among 291 women attending it. Lastly, structured exit-interviews were conducted to assess satisfaction of patients. Data analysis was done in STATA Version 10. Results There was an overall staffing gap of over 40%, while infection control facilities, drugs and supplies were inadequate. However, there was good existence of physical infrastructure and diagnostic equipment for ANC services. It was observed that counseling for risk factors and birth preparedness was poorly done; in addition essential tests were not done for the majority of clients. Conclusion To improve the quality of ANC, interventions need to improve staffing, infection control facilities and drug-supplies. In addition to better counseling for risk factor-recognition and birth preparedness.Pan African Medical Journal 2012; 13:27
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- 2013
17. Lessons learnt during the process of setup and implementation of the voucher scheme in Eastern Uganda: a mixed methods study
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Bua, John, primary, Paina, Ligia, additional, and Kiracho, Elizabeth Ekirapa, additional
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- 2015
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18. Cost-effectiveness analysis of a voucher scheme combined with obstetrical quality improvements: quasi experimental results from Uganda†
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Alfonso, Y Natalia, primary, Bishai, David, additional, Bua, John, additional, Mutebi, Aloysius, additional, Mayora, Crispus, additional, and Ekirapa-Kiracho, Elizabeth, additional
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- 2013
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19. Do Transport Vouchers Using Local Available Means Increase Attended Deliveries? A Case Study of a Rural Community in Uganda
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Mutebi, Aloysius, primary, Bishai, David, additional, Bua, John, additional, and Ekirapa, Elisabeth Kiracho, additional
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- 2013
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20. Quality of Antenatal care services in eastern Uganda: implications for interventions
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Tetui, Moses, primary, Ekirapa, Elizabeth Kiracho, additional, Bua, John, additional, Mutebi, Aloysius, additional, Tweheyo, Raymond, additional, and Waiswa, Peter, additional
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- 2012
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21. Increasing access to institutional deliveries using demand and supply side incentives: early results from a quasi-experimental study
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Ekirapa-Kiracho, Elizabeth, primary, Waiswa, Peter, additional, Rahman, M Hafizur, additional, Makumbi, Fred, additional, Kiwanuka, Noah, additional, Okui, Olico, additional, Rutebemberwa, Elizeus, additional, Bua, John, additional, Mutebi, Aloysius, additional, Nalwadda, Gorette, additional, Serwadda, David, additional, Pariyo, George W, additional, and Peters, David H, additional
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- 2011
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22. Risk factors and practices contributing to newborn sepsis in a rural district of Eastern Uganda, August 2013: a cross sectional study
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Mukanga David, Bua John, Lwanga Mathias, and Nabiwemba L Elizabeth
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Adult ,Male ,Rural Population ,medicine.medical_specialty ,Pediatrics ,Staphylococcus aureus ,Adolescent ,Newborn care ,Cross-sectional study ,Population ,Breastfeeding ,Mothers ,Prenatal care ,General Biochemistry, Genetics and Molecular Biology ,Infant, Newborn, Diseases ,Sepsis ,Young Adult ,Risk Factors ,medicine ,Odds Ratio ,Humans ,Uganda ,education ,Medicine(all) ,education.field_of_study ,Models, Statistical ,business.industry ,Biochemistry, Genetics and Molecular Biology(all) ,Mortality rate ,Infant, Newborn ,Newborn Sepsis ,Prenatal Care ,General Medicine ,Staphylococcal Infections ,medicine.disease ,Infant mortality ,Cross-Sectional Studies ,Emergency medicine ,Health education ,Female ,business ,Research Article - Abstract
Background In Uganda, newborn deaths constituted over 38 % of all infant deaths in 2010. Despite different mitigation interventions over years, the newborn mortality rate is high at 27/1,000 and newborn sepsis contributes to 31 % of that mortality. Therefore, improved strategies that contribute to reduction of newborn sepsis need to be developed and implemented. Understanding the context relevant risk factors that determine and practices contributing to newborn sepsis will inform this process. Methodology A cross sectional study was conducted at Kidera Health Centre in Kidera Sub County, Buyende district between January and August 2013. A total of 174 mothers of sick newborns and 8 health workers were interviewed. Main outcome was newborn sepsis confirmed by blood culture. Independent variables included; mothers’ demographics characteristics, maternal care history and newborn care practices. The odds ratios were used to measure associations and Chi square or Fisher’s exact tests to test the associations. 95 % confidence intervals and P values for the odds ratios were determined. Logistic regression was conducted to identify predictor factors for newborn sepsis. Results 21.8 % (38/174) of newborns had laboratory confirmed sepsis. Staphylococcus aureus was the commonest aetiological agent. Mothers not screened and treated for infections during antenatal (OR = 3.37; 95 % CI 1.23–9.22) plus inability of sick newborns to breast feed (OR = 3.9; 95 % CI 1.54–9.75) were factors associated with increased likelihood of having laboratory confirmed sepsis. Women not receiving health education during antenatal about care seeking (OR 2.22; 95 % CI 1.07–4.61) and newborn danger signs (OR 2.26; 95 % CI 1.08–4.71) was associated with laboratory confirmed newborn sepsis. The supply of antibiotics and sundries was inadequate to sufficiently control sepsis within health facility. Conclusion Lack of antenatal care or access to it at health facilities was likely to later result in more sick newborns with sepsis. Poor breastfeeding by sick newborns was a marker for serious bacterial infection. Therefore district sensitization programs should encourage women to attend health facility antenatal care where they will receive health education about alternative feeding practices, screening and treatment for infections to prevent spread of infections to newborns. Supply of antibiotics and sundries should be improved to sufficiently control sepsis within the health facility.
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23. Balancing the cost of leaving with the cost of living:drivers of long-term retention of health workers: an explorative study in three rural districts in Eastern Uganda
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Namusoke Kiwanuka, Suzanne, Akulume, Martha, Tetui, Moses, Muhumuza Kananura, Rornald, Bua, John, and Ekirapa-Kiracho, Elizabeth
- Abstract
ABSTRACTBackground: Health worker retention in rural and underserved areas remains a persisting problem in many low and middle income countries, and this directly affects the quality of health services offered.Objective: This paper explores the drivers of long-term retention and describes health worker coping mechanisms in rural Uganda.Methods: A descriptive qualitative study explored the factors that motivated health workers to stay, in three rural districts of Uganda: Kamuli, Pallisa, and Kibuku. In-depth interviews conducted among health workers who have been retained for at least 10 years explored factors motivating the health workers to stay within the district, opportunities, and the benefits of staying.Results: Twenty-one health workers participated. Ten of them male and 11 female with the age range of 33–51 years. The mean duration of stay among the participants was 13, 15, and 26 years for Kamuli, Kibuku, and Pallisa respectively. Long-term retention was related to personal factors, such as having family ties, community ties, and opportunities to invest. The decentralization policy and pension benefits also kept workers in place. Opportunities for promotion or leadership motivated long stay only if they came with financial benefits. Workload reportedly increased over the years, but staffing and emoluments had not increased. Multiple job, family support, and community support helped health workers cope with the costs of living, and holding a secure pensionable government job was valued more highly than seeking uncertain job opportunities elsewhere.Conclusion: The interplay between the costs of leaving and the benefit of staying is demonstrated. Family proximity, community ties, job security, and pension enhance staying, while higher costs of living and an unpredictable employment market make leaving risky. Health workers should be able to access investment opportunities in order to cope with inadequate remuneration. Promotions and leadership opportunities only motivate if accompanied by financial benefits.
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- 2017
- Full Text
- View/download PDF
24. SUSPECTED OUTBREAK OF CUTANEOUS ANTHRAX IN KASESE DISTRICT, THE INVESTIGATION AND RESPONSE, APRIL TO MAY 2007.
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Bazeyo, William, Lukwago, Luswa, Wamala, Joseph, Obayo, Siraj, Bua, John, Ecumu, John, Baluku, Pedson, and Mukobi, Peter
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ANTHRAX , *BACILLUS anthracis , *ANTIBIOTICS , *VACCINES , *EPIDEMIOLOGY - Abstract
Background: A report of suspected anthrax was submitted by the Kasese District Health Office to the Epidemiology Surveillance Division of Ministry of Health. A joint team comprising officers from MOH, IPH and MPH officers proceeded to the district to investigate the reported threat of anthrax. The investigations were conducted in Bwera HSD, Bukonjo West County, in communities bordering Queen Elizabeth National Park. Objectives: The main objectives of the study were to verify the existence of anthrax and assess the risk factors for the suspected outbreak of anthrax in Kasese district. Methods: The methods involved discussion with the DHT members; reviewing the surveillance data and hospital records, and reorienting the case definitions to the specific type of anthrax. In addition tracing the reported cases in the community in order to establish exposure to the risk factors and sensitize the community. Results: Cutaneous anthrax was clinically diagnosed as the cause of the reported anthrax, both from the medical records and observation of cases found during the investigation. The index case was a 44 year old male, from Hurukungu village, Kyempara parish, a household with one wife and 4 children. This case skinned a goat that had died under mysterious circumstances and the meat was eaten with family members. Two other cases were members of the same family and the fourth case was from the same community and bought meat from the index case. All the four cases presented with a history of blister like lesions that eventually ulcerated with swelling of surrounding skin in different parts of the body. There were no other systemic symptoms reported in all the cases. All the suspected cases received antibiotics to which anthrax is sensitive. There were no laboratory investigations done by the time of the investigations since many of the cases identified were already on treatment and recovering from the infection, therefore no samples were taken from them. Review of records revealed that reporting of anthrax has continued since the year 2005 with cases ranging from 1 to 4 from villages that shares a common boarder with Queen Elizabeth National Game Park. This particular outbreak was associated with eating of meat from a goat that had died of unknown cause. The health workers from the health units where cases were reported were found to have the basic knowledge and skills to suspect anthrax. However, they had no guidelines to help them identify cases of anthrax accurately. The available Standard Case Definition (SCD) booklets, IDSR Technical Guidelines, and laboratory SOPs have no information on anthrax. No samples have ever been removed from suspected cases for laboratory investigation. The health units have the appropriate antibiotics for treatment of suspected case. The Local Council Chairpersons, Veterinary extension workers, and the health educators have sensitized the community in the past against eating dead animals and that they should notify the authorities, and bury all dead animals immediately. However this hasn't yet been done for the current outbreak. Conclusion: The outbreak of anthrax in Bwera sub-county followed eating of meat from a goat which had died from unknown causes. Suspected cases have not been confirmed by laboratory but treated empirically with antibiotics. All new cases of suspected anthrax that report at the lower health units without laboratory facilities should be referred to hospital for investigation to confirm the diagnosis. There is need to include guidelines on anthrax in the SCD Booklets, laboratory SOPs and IDSR technical guidelines. Resensitization of the affected communities about the prevention of anthrax should be done immediately. [ABSTRACT FROM AUTHOR]
- Published
- 2009
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