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Abstract Background Uganda, like many developing countries, is committed to achieving the Millennium Development Goals (MDGs) by 2015. However, serious challenges prove to hamper the attainment of these goals, particularly the health related MDGs. A major challenge relates to the human resources for health. The health system in Uganda was decentralised in the 1990s. Despite the health sector reforms, the services have remained significantly deficient and performance of health workers is thought to be one of the contributing factors. The purpose of this study was, therefore, to investigate the performance of health workers after decentralisation of the health services in Uganda in order to identify and suggest possible areas for improvement. Methods A cross-sectional descriptive survey, using quantitative research methods was utilised. A structured self-administered questionnaire was used to collect quantitative data from 276 health workers in the districts of Kumi, Mbale, Sironko and Tororo in Eastern Uganda. The health workers included doctors, clinical officers, professional nurses and midwives. The sample was selected using stratified random sampling. The data was analysed using SPSS version 18.0 and included both univariate and bivariate analysis. The results were presented in tabular and text forms. Results The study revealed that even though the health workers are generally responsive to the needs of their clients, the services they provide are often not timely. The health workers take initiatives to ensure that they are available for work, although low staffing levels undermine these efforts. While the study shows that the health workers are productive, over half (50.4%) of them reported that their organisations do not have indicators to measure their individual performance. The findings indicate that the health workers are skilled and competent to perform their duties. In general, the results show that health workers are proficient, adaptive, proactive and client-oriented. Conclusion Although Uganda is faced with a number of challenges as regards human resources for health, the findings show that the health workers that are currently working in the health facilities are enthusiastic to perform. This may serve as a motivator for the health workers to improve their performance and that of the health sector.

The Integrated Management of Childhood Illness Computerised Adaptation and Training Tool (ICATT) is an emergent training tool for improving the efficiency of the Integrated Management of Childhood Illness (IMCI) case management training in an in-service or pre-service context. This article reports on a study that explored nursing campuses' readiness to use ICATT. A qualitative, exploratory, descriptive design was employed at 10 nursing campuses in KwaZulu-Natal (KZN), South Africa. Campus principals, nurse educators and learners were purposively sampled. The inclusion criteria were: for the campus principals - their willingness to participate; for the nurse educators - having received and facilitated IMCI case management training; and for the learners - being either second or third year trainees in the R425 training programme. In-depth semi-structured interviews were conducted to collect data from the seven campus principals, while eight focus group discussions (FGDs) were held with the nurse educators and learners. The interviews were audio-taped and transcribed verbatim. Data analysis was conducted manually, and trustworthiness was ensured. The determinants identified were: a positive attitude; enablers for ICATT implementation; and barriers to ICATT implementation. However, the barriers could have an impact on the adoption of an electronic tool for IMCI case management training. Recommendations include developing the infrastructure at nursing campuses; offering nurse educators training on the implementation of ICATT for teaching; and developing the learners' computer skills. Nurse educators may use ICATT effectively in teaching IMCI case management, while also stimulating independent learning and creativity for the learners involved. [ABSTRACT FROM AUTHOR]

Background: Access to affordable and effective health care is a challenge in low- and middle- income countries. Out-of-pocket expenditure for health care is a major cause of impoverishment. One way to facilitate access and overcome catastrophic expenditure is through a health insurance mechanism, whereby risks are shared and financial inputs pooled by way of contributions. This study examined factors that influenced the enrolment status of dairy farmers in Western Kenya to a community health insurance (CHI) scheme. Methods: Quantitative, cross-sectional research was used to describe factors influencing the enrolment in the CHI scheme. Quota and convenience sampling was used, recruiting a sample of 135 farmers who supply milk to a dairy cooperation. Data were collected using a structured interview schedule and analysed using Stata SE, Data Analysis and Statistical Software, Version 12. Results: Factors influencing non-enrolment were identified as affordability (40%; n = 47), unfamiliarity with the management of the scheme (37%; n = 44) and a lack of understanding about the scheme (41%; n = 48). An exploratory factor analysis was used to reduce the variables to two factors: information provision and understanding community health insurance (CHI). Logistic regression identified factors associated with enrolment in the Tanykina Community Healthcare Plan (TCHP). Supplies of less than six litres of milk per day (OR: 0.22; 95% CI: 0.06-0.84) and information provision (OR: 8.77; 95% CI: 2.25-34.16) were significantly associated with enrolment in the TCHP. Nearly 30% (29.6%; n = 40) of the respondents remarked that TCHP is expensive and 17% (n = 23) asked for more education on CHI and TCHP in an open-ended question. Conclusion: Recommendations related to marketing strategies, financial approach, information provision and further research were outlined to be made to the management of the TCHP as well as to those involved in public health. [ABSTRACT FROM AUTHOR]