Master of Science in Public Health

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Adherence and Associated Factors to Intergrated Management of Malaria Guidelines in Lake Shore Facilities in the Districts of Buyende and Kaliro, Uganda
(International Health Sciences University., 2016-11) Kaula, Henry
Background: Malaria is a life-threatening disease. In Uganda, the Ministry of Health adopted the artemisinin combination therapy (ACT) artemether/lumefantrine (AL) 20mg/120mg as the first-line treatment for uncomplicated malaria in 2004(MoH, 2012). Further, Uganda also adopted the WHO (2012) guidelines of testing all suspected cases of malaria prior to treatment (MoH, 2012). It’s unclear whether health care providers in these districts adhere to the Ministry of Health (2012) guidelines for malaria management. Objectives of the study: The objective of this study was to assess level of adherence and associated factors to national malaria management guidelines by health providers in lake shore areas in Uganda. Methods: A cross sectional study design used and data was collected from patients and providers from selected health facilities. A total of 286 patients were screened and 197 were eligible and consented to participate in the study. A total of 26 health care providers were interviewed. Results: Appropriate medical history taking and physical examination was only reported by 8.1% of the patients, 65.5% were tested either using Rapid Diagnostic Testing kits (RDTs) or microscopy. Only 6.1% reported adherence to appropriate medical history & appropriate physical examination and testing for malaria. Regarding adherence to prescription guidelines, 18.6% of those who tested negative received an ACT drug/prescription, and 10.1% tested positive but did not receive an ACT drug or prescription. Overall adherence to all guidelines (medical history, physical examination, testing, and prescription) was a mere 3.1% and health care provider training on the guidelines was the only factor associated with adherence. Conclusion and recommendations: The overall level of adherence to the national malaria management guidelines was very low with only 3.1% of the patients managed in strict adherence to the national malaria management guidelines by the health care providers. This calls for health care provider trainings on malaria management to improve adherence.
Adherence of health workers to the integrated child health care management protocols:
(International Health Sciences University, 2012-09) Vunni Draiko, Christopher
ABSTRACT Introduction: Following the adoption of IECHC in Republic of South Sudan, many counties including Magwi started implementing the guidelines. However, there is no evidence that health workers adhere to the recommended IECHC guidelines in Magwi County in Republic of South Sudan. Objective: The main objective of the study was to assess the adherence of health workers to the integrated Essential Child Health Care guidelines for assessing and managing children from 2 months to 5years of age. Methodology: A cross sectional descriptive study was conducted at 49 government and private health facilities in Magwi County. Data was collected through observation of health workers by using checklists on their encounter with sick children and carrying out key informant interviews and Focus Group Discussions with the health workers in all the 49 health facilities in Magwi County in Republic of South Sudan. An observational checklist modified from the multi Country Evaluation tool for IMCI developed by the WHO/UNICEF was used during the study. The study was conducted between the months of mid July and mid September 2012. All the health workers working in Magwi County and were present at the time of visit were observed. All the One hundred Ninety Seven (197) health workers in Magwi County were interviewed and also observed examining a total of 334 sick children. The quantitative data was analyzed using SPSS soft ware and the data presented in form of tables, graphs and charts while the qualitative data was manually analyzed and presented in verbatim and phrases. Results: Most of the health workers managing children were community health workers (CHW) 49.2%. (Chi square 19.062, df1, P<0.00) Only 25% of the health workers checked or classified for general danger signs. The health workers had deficiencies in assessing and classifying anemia and malnutrition and most of the classifications for the main symptoms were incorrect. The health workers prescribed correctly the needed drugs for malaria ;( Chi square 72.17, df 1, P<0.00) however, antibiotics were unnecessarily given in other conditions when not needed. 49.2% of the health workers checked for immunization status, 44.1% checked for vaccination card, polio vaccines BCG and vaccines respectively. Only 30% of the health workers administer or send the sick child for immunization during the day of observations. The result has shown some adherence to IECHC guidelines on counseling of caretaker on home treatment as 86% of the health workers explained to the caretakers how to administer oral antibiotics, 96.5% explained on anti malarial drug, 66% of health workers explained how to give ORS and 66% of Zinc respectively. However there was non - adherence of health workers to the guidelines on showing the caretaker how to administer the oral medications at home and asking questions to understand the caretaker. The study indicated that only 25% of the health workers used the IECHC chart book during their consultations. Majority 75% of the IECHC health workers did not used the chart booklets. Therefore the study found out that there is non- adherence to the use of the guideline. On treatment of the various classifications by the health workers, majority (85%) of the health worker adhered to treating malaria. Many of the health workers treated both incorrect and correct classification. Further The study also found out that health workers prescribed antibiotic medication to the sick children, some of this antibiotic were not warranted and could be based on the essential list of not on the IECHC guidelines. There adherence to counseling of the caretaker on home treatment by health worker was poor; The result indicated that only 39.4% health workers counsel the mother on giving fluids and continued breastfeeding , 27% on how to administer treatment at home , 22% counsel the caretakers on when to return immediately. Furthermore 72.1% of the health did not assessed for child’s feedings, 75.2% did not assed or asked if the child feeding had changed and 66.5% never ask about fluid and other feeds. This is clear indication of non adherence to the implementation of IECHC guideline. The study found out that majority of the health facilities had essential drugs for the IECHC essential oral drugs during the observational period. However over 75% of the facilities do not have inject able IECHC care drugs as pre referral treatment and for those children who cannot take oral treatment. There has been marked improvement in the health systems and essential drug for IECHC although despite 50.6% of the health facilities were not having functional fridge and available vaccines for immunization Conclusion/Recommendations: The study found out that the adherence of heath workers to the IECHC guidelines in Magwi County poor. However due to the introduction of IECHC, there has been substantial improvement in the health systems factors like drugs and capacity of health facilities especially equipments.
Adherence to Infection control measures Among Heath workers in Private Health Centres in Kampala district.
(International Health Sciences University., 2015-12) Christine, Namutebi
Introduction The research was about adherence to infection control measures among health workers in private health centres in Kampala district. Infection control was the area of interest as it is still not given too much attention in the developing countries yet causes one of the most unnoticed risk to lives of health workers as well as the clients and their care takers. The research objective was majorly to assess the level of adherence to infection control measures among health workers in private health centres in Kampala district. Method The sample size was calculated using the Kish and Leslie formula from which 185 respondents were to participate in the study. A questionnaire with both open-ended and closed questions was then filled by the select respondents who were randomly selected from the general cluster of health workers in private health centres in Kampala district. Data collected were entered using Epi-data and analyzed using the Statistical Package for Social Scientists; version 20. Binomial and bivariate tests were run with the level of significance of 5% that is p = 0.05. Results From the analysis, the level of adherence to administrative infection control measures was the highest at 81.19%. Level of adherence to environmental infection control measures was 66.85% while that for adherence to infection to personal protective infection control measures was the lowest at 60.40%. Of the factors that affected adherence to infection control measures, job satisfaction, good work environment communication and on-job CME were the most significant with a p-value of 0.000. Having attended training on infection control measures was significant as well (p =0.003). In addition to that, staff supervision and facilities having copies of infection control guidelines were the most insignificant with a p –value of 0.659. Analysis of the descriptive factors presented minimum number of health-care staff at a given facility as the factor that would affect the average number of clients attended to within a given period of time. These two were strongly positively correlated. Conclusions Health-care Associated Infection is one of the least catered for risks in health-care service delivery, most especially in the under developed countries, though a potentially preventable adverse event than an unpredictable condition. The connotation of this is it is always prevailing and can occur in any health-care setting. This calls for prompt compliance to all the infection control measures. Prompt compliance to infection control measures would not only avert association with host barrier, but transmission between and amongst individual (health-care staff, clients and care takers at the facility) as a whole. Recommendations Some of the suggested ways to increase adherence to infection control measures among the health workers in private health centres were facility heads being taught the benefit of credit saving societies amongst themselves for increased financial base, periodic survey of these health centres fo compliance, sensitization of populations about the necessities towards infection control while visiting the health centres and health workers embracing Continuing Medical Education to conquer evolution of ill-health disease causing organisms.
Adherence to Infection Control Practices Among Barbers in Kampala Capital City 2012.
(International Health Sciences University, 2012-09) Ssekaboga, David
Introduction There is a big concern that barbering procedures could expose both barbers and their clients to various infections. These infectious diseases and conditions that can be spread through barbering procedures include; skin diseases like dermatitis, fungal infections, and viral infections like HIV, Hepatitis B, and Hepatitis C among others. However, little is known about adherence to infection control among barbers in Kampala City. Objectives The main objective of this study therefore was to establish adherence to infection control practices among Barbers in Kampala Capital City. The study was particularly interested in establishing the availability and safety level of equipment used by barbers, determining the barber factors as regards infection control and establishing the implementation of barbering policy issues by different regulatory bodies. Methodology This was a cross sectional study that utilized both qualitative and quantitative methods of data collection. A hundred and eight barbershops were involved in the study; one barber from each of the barbershops was interviewed and observed. The barbershops were selected using systematic random sampling while the barbers within the barbershop were selected using simple random sampling. An observation checklist, questionnaire and key informant guide were used to collect data. Quantitative data entry and analysis was done using SPSS version 3.5.1 and Microsoft Excel 2010 software. Qualitative data was analysed using the thematic approach. Results All the barbers that were interviewed were males. The findings of this study revealed that most barbershops did not have sterilizers (55.5% of all barbershops) while only 40% of all sterilizers were found to be functional. There was a significant association between the education level of the barbers and the level of safety of equipments used in the barbershop. (X2 =12.469, P= <0.014), with the barbers with a high education level being more likely to have equipments processed to a higher safety level compared to their counterparts with low education level. Most of the barbers (69.4%) do not examine the clients’ head for infections prior to shaving and majority (91.7%) admitted that they just continue with the shaving process when they identify infections on the clients’ scalps. The utilization of PPE was low; gloves and aprons were found to be used by very few barbers that is; 9.3% and 23.1% of all the barbers respectively. Apron use was more common among barbers with high equipment safety level (X2=10.082, p= 0.003). as compared to those in the category of low equipment safety level. Only in 18% of all barbershops that were involved in the study had hand washing done yet 91.7% of all barbershops that were involved in the study had water available. While only 8.3% of all the barbers washed their hands with soap before beginning shaving. The key informants from UNBS stated that their role was only to set up standards for KCCA public Health Department to enforce, however, key informants from KCCA attributed their lack of regulation of barbers to low facilitation of the department and the general low priority given to environmental health activities in the authority. Conclusion The study found that barbers in Kampala City generally do not adhere to infection control practices exposing themselves as well as their clients to various infections. It was discovered that majority of the barbers did not sterilize let alone disinfect shaving equipment with potent disinfectants between clients. The Local Authority was not active in regulating the establishment and operation of barbershops and inspecting the premises to assess their suitability for the purpose.
Adherence to Infection Control Practices in Hospital Wards in Makindye Division, Kampala District.
(International Health Sciences University., 2013-09) Jane, Mugga Settuba
Introduction: Patients seek health care from hospitals because of various illnesses in order to live healthy lives. It is therefore the responsibility of the hospital to ensure that the patients get proper treatment while in hospital and to prevent any further infection while in the hospital setting. This is done by observing standard infection control practices in the hospitals However, adherence to affection control practices in hospital wards has not been given the attention it deserves in terms of regulating it and guiding all the hospital staff to adhere to it. This in the end has had a negative health impact of registering hospital related infections. Objective To determine adherence to infection control practices and factors affecting adherence to infection control practices in hospitals in Makindye division. Methods A descriptive cross sectional study employing both qualitative and quantitative methods of data collection was used. The study was carried out in four hospitals in Makindye division, Kampala district. Our calculated sample size using the Kish and Leslie formula was 246 respondents who were interviewed using self administered questionnaires. Twenty one observation checklists were administered in the 21 hospital departments/wards. Data was analyzed using SPSS and Epinfo Version 3.3.2 (2005) and Stata 8.2 soft ware and analysis was done in stages involving uni-variate, bivariate and multivariate analysis. Data is presented in tables, graph and chart. Results The study showed that much as the health workers were knowledgeable about infection control, 96.3% revealed it was not practiced in the hospitals were they worked. Lack of equipments to use, lack of knowledge regarding infection control practices and lack of commitment of the administrators to make supervision on infection control practice were reasons given for non adherence in the hospitals. 65% of the hospital staffs ranked the level of adherence to infection control in hospitals as low; 95.1% of the hospital staff members reported hospital acquired infections in the past two weeks, with tetanus as the most hospital acquired infection. 90.5% of the respondents had been trained in infection control practices, 55.4% from medical schools. 91.4% were in the know of at least hand washing, proper waste disposal, use of protective equipments and prevention of needle stick injuries as “specific infection control practices”. 47.9% had received the three vaccinations that is; Hepatitis, Tetanus and TB. 89.4% knew at least three situations in which they wash hands routinely with soap as “after contact with individual patients or their immediate environment” or “ before manipulating medical devices” and “after using bathrooms, toilets and latrines; 88.6% were always washing hands, 84.9% knew that hospitals had infection control guidlines,77.2% knew about the infection control guidelines as laid down by the ministry of health; 81.6% were taking action as “immediately stopping working the moment they had got needle stick injuries”.78% were putting on gloves with 93.5% washing hands after removal of gloves. 84.5% were washing hands between patients being examined. 60.8% of the health workers were wearing protective equipments always like gloves, goggles, aprons and masks. From the check lists, all hospitals had hand washing facilities. 71.4% had a hygiene policy and 42.8% were available but not displayed. 61.9% showed that the wards did not have visible swabs that were dirty, stained or wet, 81% of the wards had puncture proof disposal boxes for disposing of used needles and injection in treatment and 81% had properly well labeled waste disposal bins on the wards, 90.5% of the health workers were putting on protective equipments,61.9% showed that hospitals were disinfecting patients rooms after patient discharge, The study further revealed at 57.1% that soap was not available at hand wash facility. 71.4% of the available boxes or bins were over flowing, open and pierced, almost all people handling waste were not putting on protective wear. 52.4% did not have cleaning schedule for patients’ rooms. Of those who had cleaning schedules, 47.6% were cleaning once a day, 85.7% hospitals were changing linen only when soiled. At bivariate analysis, the staff’s training in infection control measures was associated with the level of adherence to infection control with a chi square value of 4.17 and a P-value of 0.001. Hospitals whose staff members had been trained in infection control were 1.68 times more likely to have high level of adherence to infection control as compared to those hospitals whose staff members had no training at all in infection control. The staffs’ knowledge about whether the hospital has an infection control guide was a significant factor in explaining the level of adherence to infection control with a chi square value of 5.491 and a P-value of 0.004. Hospitals whose staff members were knowledgeable about infection control guidelines/policy were 12.3 times more likely to adhere to infection control measures as compared to those hospitals whose staff members were ignorant of the guide/policy. The hospital staffs knowledge about the infection control guide as laid down by the ministry of health in Uganda, had a chi-square value of 9.065 and a P-value of 0.0011. This means that hospital which had hospital staff members ignorant of the infection control guides as laid down by Ministry of health Uganda, these hospitals were 0.379 times less likely to adhere to infection control practices as compared to those hospitals whose staff members were knowledgeable about the guide lines as laid down by Ministry of Health. The hospitals with equipments available are 12.3 times were more likely to adhere to infection control practices as compared to hospital with limited equipments is obtained at a chi square value of 8.275 and a P-value of < 0.000. The knowledge of the health workers about the hospital policy of waste management and disposal was significantly associated with the level of adherence levels to infection control practices at a chi square value of 15.921 and a P-value of 0.000. Administrative commitment on infection control practices was significant at the chi square value of 9.28 and a P-value of 0.0008. Hospitals in which the patient –health worker ratio was high were 0.25times less likely to adhere to infection control measures as compared to those with a low patient health worker ratio. This was at a chi square value of 4.296 and a P- value of 0.0005. After adjusting for confounding at the multivariate level using log likelihood ratio, all the variables ended up being significant and these variables were; Staff levels of training (OR = 2.19, 95%CI 1.70-2.492, P-value 0.000); Staff’s knowledge about infection control guides as laid down by MOH (OR= 0.34, 95 % CI -0.86-0.5, P-value 0.0016); Staff’s knowledge about hospital infection control guidelines / policy (OR=2.58, 95%CI 1.63-3.79, P-value 0.0010); Staff’s knowledge about hospital waste management policy (OR=0.36, 95%CI 0-0.023-0.58, P-value 0.0090) ; Lack of equipment (OR= 3.46, 95%CI 0.41-4.67, P-value 0.021); Staffing; that is; Patient - staff load (OR=4.24, 95%CI 2.46-8.64, P-value 0.032); Administrative commitment/ infection control supervision by infection control personnel (OR= 2.45, 95%CI=1.04-2.967, P-value 0.0013) Conclusion and recommendations Continuous on job training in infection control Displaying of the recommended infection control practices within the hospitals in areas that are accessed by all staff and patients on the hospital ward, Proper allocation of materials as required; A reward systems for those identified as adherence to infection control in the hospital wards. The recommendations above will facilitate adherence to infection control practices in the hospital wards. A clear system concerning supervision of hospital wards by infection control personnel should be laid out.
Adherence to Intermittent Preventive Treatment for Malaria Among Pregnant Women in Mawokota South Health Sub-District, Mpigi District.
(International Health Sciences University, 2012-09) Nuwagaba, Denis
Introduction While the Ministry of Health since 1998 embraced Intermittent Preventive Treatment (IPT) strategy, its utilization has remained low in Uganda fluctuating between 42% and 39.6% against Health Sector Strategic Plan (HSSP) II target of 80%. In Mpigi District and Mawokota South HSD the study site utilization of IPT was estimated at 35% lower than the national coverage. The main objective of the study was to investigate factors influencing IPT utilization for malaria among pregnant women in Mawokota South Health Sub-District-Mpigi District. The specific objectives of the study were: To determine community knowledge and perceptions about IPT and level of utilization; To determine the relationship between social demographic factors of pregnant women and utilization of IPT; To determine the relationship between the economic status of pregnant women and utilization of IPT; To describe health facility related factors affecting IPT utilization. Methodology: A cross-sectional descriptive study design was adopted and both quantitative and qualitative data collection methods were used. Data was collected from 99 respondents and these included; 68 pregnant women receiving ANC services at four health facilities, 23 women participated in focus group discussions, the key informants included; 5 In-Charges of ANC clinics/maternity wards at the selected four health facilities, and 3 village health team members/community resource person. Results: The study found out that majority of pregnant women attending ANC clinics (86%) and those in FGDs had heard about IPT. Although IPT service was generally well perceived in the community with 20.6% of mothers attending ANC clinics rating it as excellent and the majority (66.7%) rating it as good, this did not translate into its timely utilization. Out of 57 pregnant mothers attending ANC clinics, only 24.6% can be categorized as good IPT utilization practice compared to a majority 75.4% which represent poor IPT utilization practice. Like earlier studies, background characteristics of respondents were found to impact on IPT utilization. The study found that younger pregnant women (16-25 years) had a good IPT utilization practice estimated at 14% compared to 8.8% for older women (26-35 years). A mix of service delivery factors such as rudeness of health workers, costs involved to obtain IPT, limitations at health facilities in delivery of IPT and gaps in information about IPT by health workers plus community barriers such as poor perceptions and limited access contributed to low utilization of IPT. These findings imply that if factors contributing to low utilization of IPT are not addressed, Uganda is not likely to meet MDG goal of reducing the unacceptably high maternal mortality rate (435 deaths per 100,000 live births). Malaria is a major cause of illness and death among pregnant women. Recommendations: The study recommends that government should build on the good DOTs for IPT strategy to bridge the information gaps and overcome unfounded community fears by refreshing health workers’ knowledge and skills and intensifying community awareness and their involvement in IPT service delivery. This is expected to enhance utilization and contribute to the realization of set IPT targets. It is also recommended that further research be carried out about the influence of social economic factors on utilization of IPT. Research should also be conducted about the extent to which the fear of taking HIV test as part of ANC has affected IPT uptake and utilization.
Adherence to Iron-Folic Acid Supplementation and Associated Factors:
(International Health Sciences University., 2016-11) Ndungutse, Amos; Hashaka
Introduction: Adherence to iron folic acid supplementation is a very important issue in combating iron deficiency anemia. Yet there are many factors ranging from individual, socio-economic and health facility related that contribute to this low adherence. This study focused on the adherence among pregnant women in second trimester at Gulu regional referral hospital in northern Uganda. Objective: To establish the proportion of adherence to iron- folic acid supplementation and the associated factors among pregnant women attending Antenatal at Gulu regional hospital-northern Uganda Methods: A cross sectional study design employing quantitative and qualitative approaches were used to determine level of adherence to iron folic acid supplements and factors associated among pregnant women attending antenatal care at Gulu regional hospital. A sample of 402 pregnant women in their second trimester and two key informants were selected through purposive sampling method to be interviewed. Results: The results shows that proportion of adherence was 63.7% and the factors which were significantly associated with it included number of children (p-value of 0.000) number of times the mother was taking (p-value of 0.003), number of months (p-value of 0.033, willingness to continue taking (p-value of 0.000); knowledge on the how many iron folic acid supplement Knowledge on the importance and how to manage side effects after taking iron folic acid supplements (p-value of 0.000) having seen posters on iron folic acid supplements. Conclusion: The proportion of adherence was high among pregnant women at Gulu regional referral hospital and the factors such as number of children, number of weeks, number of months and knowledge of the women on importance and management of side effects were significantly associated with high levels of adherence. Recommendations: Pregnant women should report early for antenatal services so that the health workers can be able to provide to them all the components of goal oriented ANC Pregnant women should use other available sources of information about iron folic acid supplementation not only the radio but through peer to peer groups and the mother in laws who have experience in child upbringing.
Adherence to Laboratory Quality Management Practices:
(2014-11) Nyanda, John Bosco
The study titled: Adherence to Laboratory Quality Management Systems (LQMS) in Private Not For Profit (PNFP) laboratories in Kampala District, was conducted at the four (4) PNFP facilities of Nsambya, Kibuli, Lubaga and Mengo hospitals in Kampala. The main objective: The study was set out to assess the level of adherence to LQMS practices in PNFP hospital labs in Kampala. Specifically to: Assess the process factors influencing adherence to practice of LQMS, assess the human resource factors influencing adherence to practice of LQMS, and assess the facility factors affecting adherence to the practice of LQMS. Methodology: The study was a descriptive cross-sectional survey. Standard WHO-AFRO observational checklist and key informant (quantitative) questionnaire guide data collection tools were utilized. Four (4) lab managers and eight (8) quality officer or safety officers participated in the study. The study evidently achieved the objectives set forth. Results: The study found out that, Lab 1 (Mengo) adhered at 79.07%, Lab 2 (Nsambya) adhered at 86.43%, Lab 3 (Lubaga) adhered at 58.53%, and Lab 4 (Kibuli) adhered at 59.69%. Specifically the study findings were that process factors were the major factor influencing the adherence to practice of LQMS as 3⁄4 labs scored below 50%, in management review 3⁄4 labs scored below 7/17 (41%). In internal audits all the PNFP labs scored below 4/10 (40%), in process control 2 of the labs scored below 19/33 (58%). Corrective action and occurrence management 2 of the labs scored below 4/12 (29%) respectively. The main human resource factors influencing the practice of LQMS were identified as lack of competency assessment, quality officers, training policies, procedures, plans and mentorship. The facility and safety indicated equipment validation and calibration was influencing the quality system and 2 of the labs scored poorly 26/43 (62%) each in infrastructure and safety installations. Human resource factors were 3⁄4 labs scored below 13/20 (65%), in facility and safety 2 of the labs scored 26/43 (65%) respectively. There was no significant difference in the process factors (p-value <0.001). The ANOVA statistics indicates positive regression model at p=0.042. The process factors were found to be the most influential factor in the practice of LQMS. Conclusion: The study established that process factors influenced the practice of LQMS more than the human resource, equipment and the facility and safety factors, evidenced by the process factors constituting 70% of the checklist questions and the poor performance in the process factors like internal audits. Recommendations: Based on the study findings, the major recommendations included; initiation and regularize the conduct of lab audits as a means of gap identification and opportunity for continuous quality improvement. Conduct regular management reviews, the lab managers should participate in facility management and budget meetings where resource allocations decisions are made. Lab managers should ensure conduct of internal audits, process control, quality assurance and quality control, proficiency testing, external quality assessment, occurrence management and instituting corrective action. Conduct staff competency assessment, identify training needs of the different cadres, and develop plans for trainings. The facility should develop clear lab organogram, with well-defined roles and responsibilities of each level to improve the chain of command within the lab. Labs should participate in equipment validation and calibration exercises to ensure precision and accuracy of aliquots. In line with need for further inquiry, the study identified the following areas for further research; the influence of attitude on the practice of LQMS, the influence of training and mentorship on practice of LQMS and influence of cost of quality on practice of the LQMS.
Adherence to laboratory test results in the management of malaria in KCCA health centers in Kampala city, Uganda.
(International Health Sciences University., 2015-12) Sule, Shuaibu; Umaru.
Introduction: This study aimed at assessing the levels of adherence to laboratory test results in the management of malaria in KCCA health centers in Kampala City, Uganda. This was on the basis of the facts that the prescription practices of health workers in malaria management investigated in earlier studies appeared not to have changed despite the various strategies on dissemination exercise of these guidelines and policy by Uganda MoH. Objectives: The study had three specific objectives; To determine the level of adherence by health workers to laboratory test results in the management of malaria, to identify health worker factors affecting adherence to laboratory test results in the management of malaria, and to identify the health facility factors affecting adherence to laboratory test results in the management of malaria in KCCA health centers in Kampala City, Uganda. Methodology: Cross-sectional survey design was adopted for this study. Secondary data was collected using documents review from outpatient’s records, laboratory test for malaria and Acts prescription records for the month of June, July and August, 2015 to establish level of adherence in the health centers. Primary data was collected using self-administered questionnaires, focus group discussions and key informant interviews to establish other factors affecting adherence to laboratory test results in the management of malaria following the WHO/ MoH policy guidelines. Data was analyzed using Epi-data and SPSS which was presented using descriptive statistics of frequencies and percentages. The chi-square test was used as bivariate analysis to test the level of association between the variables of the study while logistic regression was used as multivariate analysis to determine the influence of the independent variables on the dependent variable. Findings: Documents reviewed from the health centers revealed low levels of adherence to laboratory test results in the management of malaria during the months of June, July and August, 2015. Findings from this study revealed that of the 15,169 patients treated with ACTs in the health centers, up to 13,309(87.7%) were either malaria negative or not tested. The level of compliance to WHO/UNMCP malaria treatment guidelines was only 12.3% which is very low. There is significant association between; Awareness of the policy (χ2 = 7.759, p = 0.008, and AOR = 4.307), Health worker attitudes (χ2 = 9.041, p = 0.029 and AOR = 0.415) and Results delivery time (χ2 = 13.650, p = 0.000 and AOR = 6.884) on the dependent variable. Conclusion and Recommendations: The study revealed that adherence to laboratory test results in the management of malaria in KCCA health centers, Kampala City as generally low. Therefore MoH and KCCA should plan new strategies that should be used to ensure policy implementation in order to achieve the benefit of adherence to laboratory test results in the management of malaria as recommended by WHO.
Adherence to safety measures among employees of crown beverages limited in nakawa division, kampala capital city authority.
(International Health Sciences University., 2015-12) Nsereko, Patrick
Industrial workers are exposed to hazards in their work places as they engage in routine work, these hazards include physical, chemical, biological and mechanical. To reduce on the effect of these hazards, employees are provided with PPE as a last resort to prevent them from hazards that cannot be eliminated completely. The study on adherence to safety measures among employees of crown beverages limited was conducted to establish the factors that have contributed to non-adherence. The specific objectives of the study were; to establish workers level of knowledge on safety measures, to establish the effect of sociodemographic factors on adherence, to determine the practices and attitude of workers towards the use of PPE. A descriptive cross sectional study using a study sample of 201 respondents was employed using both Quantitative (Questionnaires) and Qualitative (Key informants and Observation) data collection methods were employed. Results from the study indicated 195 (97%) of the respondents were knowledgeable while 5 (2.5%) were not, the study also reflected 93 (46.3%) of the respondents had negative attitude towards the use of PPE while 102 (50.7%) had a positive attitude. The results showed an association between adherence and gender at p – value of 0.002 and adherence and occupation at p – value of 0.026, an association between number of years an individual has spent at work and adherence at p-value 0.011 and an association between occupation and adherence at p-value 0.028. Based on the study, it was evident that the main factor affecting adherence to safety measures among employees of crown beverage limited was negative attitude of the employees towards the use of PPE. It’s therefore paramount for management of crown beverages limited to institute measures that can change the mind set of individuals but also to introduce tough measures for those individuals found in violation of the set safety measures.
Adherence to the Sewerage Treatment Plant Guidelines in Kampala:
(International Health Sciences University., 2016-11) Opoka, Paula; Sandra
Background: The study examined the level of adherence to the sewerage treatment guidelines at Lubigi sewage treatment plant.The study objectives were to;determine the safety management systems influencing adherence to the sewerage treatment guidelines at Lubigi sewage treatment plant; establish the safety environment aspects influencing adherence to the sewerage treatment guidelines at Lubigi sewage treatment plant and establish the employee safety commitment aspects influencing adherence to the sewerage treatment guidelines at Lubigi sewage treatment plant. Methods: The study used a cross sectional study design and data was collected from a sample of53respondents, self-administered questionnaires; and documentary review guides were used in the study. Results: The study results established that adherence to sewage treatment guidelines was significantly influenced by restricting exit or entry for authorized person to the sewage treatment area (X2 4.7,p-value 0.03). The study result established a significant relationship between level of adherence to sewage treatment plant guidelines and health and safety measures (X2 13.032, p-value 0.000). This study established an association between the level of adherence to sewage treatment guidelines and presence of manuals. Recommendations: It is recommended that employees must be trained in several aspects of personal protective equipment, these include, when personal protective equipment must be worn; what type of equipment is necessary, how to properly adjust, wear and remove the equipment. It is recommended that the managers should organise workshops that sensitize the workers about the occupational hazards that are likely to occur and cause serious injuries.The availability of a readily written and detailed operations and maintenance procedures is very vital to the adherence of the guidelines thus it is recommended that the plant can use the manual as a point of reference.
Adherence to Tuberculosis Infection Control Measures Among Health Workers in Bombo and Nakasongola Military Referal Hospitals.
(International Health Sciences University., 2014-11) Richard, Mpangire
Agricultural Practices, Food Security and Nutritional Status of Children Under Five Years in Kateta Sub- County Serere District.
(International Health Sciences University, 2014-11) Epero, Joseph
Main objective. The main aim of the research was to describe agriculture practices, food security and nutritional status of children under in Kateta sub county where malnutrition is on the increase among children. The influence of human capital as an intervening variable in terms of the extension workers and household heads is capacity in terms of knowledge and skills plays a role in nutritional status of children and therefore very critical in this research. Methodology. The methodology employed in this research involved the use of structured questionnaires with both closed and open ended questions which were administered to respondents from sampled households. The anthropometric data for children under five was analyzed using the Epi- info 2012 version enabled the generation of Z scores standard deviations used to provide a direct assessment of malnutrition among the age group. Key informant interviews were conducted with professionals in the fields of agriculture and health and helped to enrich the study especially on recommendations for action. Results. The main findings for the research include: the average households land holding is low at 1-3 acres yet there is also underutilization and the contribution of production to food is equally low yet there is competition of use of food for consumption and income which is used for other needs; households' involvement in modern agriculture practices is low and traditional practices dominate in the sub- county; children at the age of 0-11 months are more affected by underweight while children at the age of 36- 47 months are more affected by stunting ; there is lack of joint planning between the agriculture and health personnel in order to improve nutritional status of children under five and education levels fairly are good and fairly good and provide a potential for improvement in agricultural practices hence food security and nutrition status. Conclusion and recommendations. In conclusion, poor agricultural practice have contributed to food insecurity in Kateta sub county and this has negative influence on the nutritional status of the under fives. The study recommends thus; joint planning for agriculture by agriculture and health professionals so as to improve on diets, this is in agreement with the recommendation of global food policy report (2011); promote adoption of good agricultural practices; village health teams should handle nutrition support services for children under five through education; improve agricultural extension services; support adequate planning on food utilization.
Analysis of Absenteeism Among Health Workers in Public Primary Health Facilities, Mbale District, Uganda.
(International Health Sciences University., 2014-11) Ayella, Christopher.
Introduction: The study of health workers absenteeism in public primary health facilities in Mbale District draws findings from unannounced visits of 26 public primary health facilities. The Health facilities were visited thrice a week: Monday, Wednesday, and Friday at 9.00 AM in the morning and 3.00 PM in the afternoon each day. The main objective of the study: was to analyze absenteeism among health workers in public health facilities. The specific objectives were to determine the prevalence of absenteeism among health workers in 2013, determine the factors associated with absenteeism and to estimate the financial losses incurred by Mbale District Local Government due to payment of salaries to absent health workers in public health facilities. Methodology: A total of 154 health workers out of 404 (38.1%) were followed. In-depth interviews with senior district government Officials, health facility managers, and health workers were conducted to generate qualitative data that was used to substantiate and triangulate quantitative findings. Review of available literature and documents on absenteeism were conducted to substantiate the findings. Results: The overall absenteeism rate was 46%. Wide variation was observed within the three days of the week and among professional cadres. Absenteeism rate was highest (61%) on Friday afternoon. Doctors had 100% absenteeism rate. Health workers at HCIVs were more likely to be absent from their health facilities compared to those in lower health facilities. The study established that gender was the only statistically significant factor. However, other factors associated to health workers absenteeism elicited during in-depth interviews include lack of accommodation at the health facilities leading to high transport fees incurred by health workers to and from the health facility, low salary coupled with irregular pay of the salaries. These factors were not any different from those hygiene and motivators described by Herzberg (1959). It was established that Mbale District Local Government loses a significant amount of funds worth USD 322,962(UGX 82,405,000) to payment of absent health workers. This money could pay the salary of Mbale Municipal health workers for a year. Conclusion and recommendations: Absenteeism is more than a human resources issue. It costs Mbale District Local Government millions of money each year. Unless the government starts pro-actively addressing absenteeism, lots of money will be wasted. The Ministry of Health needs to consider implementing performance- based financing, increase the frequency of supportive supervision; internal and external, strengthen control measures like the use of attendance registers, and improve on the incentives and remuneration to health workers. In conclusion, health worker absenteeism in Mbale District is likely to exacerbate human resources for health insufficiencies and undermine demand for, quality of and efficiency of delivery of health services.
Analysis of Factors That Influence Compliance With Praziquantel for the Control of Intestinal Schistosomiasis in Communities of Mpigi District, Uganda.
(International Health Sciences University., 2014-11) Ssemwanga, Edward Bamulanzeki
Background: Intestinal schistosomiasis has been a major public health problem in Uganda. Government of Uganda during 2006 initiated Mass Drug Administration (MDA) with annual single dose of praziquantel tablets to all the population living at the risk of the infection. Praziquantel (PZQ) is a drug of choice for treating schistosoma mamansoni but there are reports that indicate variations in compliance with the drug in endemic areas. Objective: To assess the factors influencing compliance with praziquantel for the control of intestinal schistosomiasis in communities of Buwama and Nkozi sub-Counties, Mpigi district, Uganda. Methods: Community based cross-sectional study was undertaken among four selected villages of Buwama and Nkozi Sub-counties in the month of August using results of May 2014 MDA compliance rates in the district. Information pertaining compliance with PZQ was gathered from 164 families and 491 respondents were recruited from 4 Villages 2 from Buwama and 2 from Nkozi by interview technique using structured questionnaire and key informant interviews. Data was analysed using SPSS version 16.0 at univariate, bivariate and multivariate levels. Findings: There was no significant difference in the compliance rate with PZQ between Buwama and Nkozi Sub-counties (χ2=0.165, p= 0.685). Eleven factors associated with compliance were identified: awareness of bilharzia (hard about bilharzias (OR=5.222, C.I=2.078-13.122, P=0.000), Vector for bilharzias (OR=1.263, C.I=1.048-1.522, P=0.014), causes of bilharzia (OR=3.222, C.I=2.168-.090), P=.000 and how we get bilharzia (OR=1.2, C.I=1.013-1.423, P=0.035), same religious affiliation as their CMDs (OR=1.372, C.I=1.078- 1.751, P=0.011), fear for the smell of the tablets of praziquantel (OR=1.128, C.I=1/001-1.270, P=0.048), dose pole (OR=2.845, C.I=1.025-1.363, P=0.022), period of stay in village xi(OR=0.585, C.I =0.471-0.727, P=0.000).Other individual factors such as age, religion and employment of respondents were not associated with PZQ compliance in the area. Gender was the only Socio –behavior factor influencing compliance with praziquantel (OR=0.632, C.I=0.434-0.919, P=0.016). Males were more compliant than the females in both Sub-counties. Other social behaviour factors not influencing compliance were: family members, health seeking behavior, mobility of respondents and having the same religious affiliation as Community Medicine Distributors. Respondents who were sensitized on the disease and its treatment were (OR=2.112, C.I=1.077-4.140, P=0.030), inadequate CMDs training to counteract negative rumors and answer questions from community members, bilharzias seen as a number four disease in the area after malaria and HIV, CMDs do not get enough incentives and allowances during MDA, proportion receiving posters and other IEC materials was found to be small in Buwama and Nkozi respectively(χ2=6.856, p=0.009 and χ2=0.627, p=0.429), there is a variation in the annual treatment period between the two Sub counties (OR=3.202, C.I=1.618-6.336, P=0.001), door-to-door distribution strategy (OR=2.032, C.I=1.749-2.295, P=0.000) mostly used in the two Sub-counties and relatively good supervision during MDA(OR=4.434, C.I=2.345- 8.387, P=0.000) are positive predictors of compliance with praziquantel. Conclusion: Results of the study identify individual, social-behaviour and program challenges to treatment adherence that are important in planning, implementing and evaluating national treatment programmes for intestinal schistosomiasis in the area. A large number of previous studies have identified community based mass-treatment interventions as an effective strategy to treat affected populations. However, limited evidence is available to discuss challenges to treatment adherence, access, delivery and monitoring at community level. The study contributes to the body of knowledge to the control of intestinal schistosomiasis in the area. It also revealed difficulties in CMDs trainings, distribution strategy, IEC distributions and community-based monitoring of MDA in both Sub-counties. Recommendations: The research findings could contribute to schistosomiasis control in the two Sub-counties of Buwama and Nkozi. They could also have implications on the control of schistosomiasis in other endemic districts in Uganda and other similar settings elsewhere. The study has contributed to a body of knowledge on intestinal schistosomiasis control that could be useful to researchers and other scientists working on a related or similar topic. Sensitisation of community members is important to increase awareness of the disease and its treatment, training of CMDs should be conducted for several days to empower them with necessary information necessary to counteract negative rumors and answer questions from community members. In addition the trainings should aim at strengthen community sensitization meetings in the effort to increase accessibility to the medicine in all endemic areas. The program should increase incentives and allowances to CMDs for several days. Increase in the distribution of IEC materials, supervision and monitoring of program activities especially in Nkozi Sub-county is important to give extra support to CMDs and streamlining the distribution strategy.
An Analysis of the Patterns of Injuries Among the Residents of Mbiko Town, Buikwe District, Uganda.
(International Health Sciences University, 2013-09) Nassozi, Rehema Ssozi
Background Injuries are a major cause of mortality, morbidity and disability world over and these are most experienced in developed countries as they are heavily industrialized. These countries invest heavily in research and prevention hence the reported incidence of injuries is relatively low. In Uganda, injuries have not made it to the priority list making it a wide spread problem that renders the injured persons helpless as the cost of treatment is not affordable to many. Hence this research will help inform policy development and planning for the prevention and care of injuries. Objectives These were: to analyse the patterns of injury among the residents of Mbiko Town Council; the type and causes of injuries, to establish the facilities of care and the effects of injuries among the residents of Mbiko Town Council. Methodology A descriptive cross sectional survey was conducted and a sample of 100 households was randomly selected from four zones namely; Kasanja, Naava, Kyabagu and Kigobe. Using a structured questionnaire, quantitative data was collected from all members of the sampled households. A focus group discussion guide was used to collect qualitative data from selected local leaders and medical practitioners who were engaged in the discussion. The quantitative data was analysed using SPSS 16.0. Participation was voluntary and ethical procedures were observed. The report will be disseminated to the participating community, International Health Science University and interested stakeholders. Results Out of the 100 respondents that were studied, road traffic accidents were suffered by people whose ages ranged from (21-40) years of age, unintentional falls, burns and animal bites were between (1-20) years of age. Most of these injuries were sustained on the roads within town and the county (43%), home (33%) and school (6%). Farms and gardens (6%), Public/office buildings (5%) and both hospital and industries (2%) finally sports (1%). Males were found to be more prone to injuries as compared to females and accounted for (57%) as compared to the females at (42%). Conclusion Injuries have been found to be a significant health problem in Mbiko Town Council as they have claimed lives, caused permanent disability, led to lost time during the treatment and recovery process and have ended careers for some of the residents. Injuries are preventable and policy need to institute measures to curb them.
Andersen Behavioral Model and Utilization of Breast Cancer Screening Services Among Kampala International University Students, Kampala District.
(International Health Sciences University., 2015-12) Maryan, Daud; Warsame
Background: Breast cancer is cancer that develops from breast tissue. Breast cancer is Public Health Problem in the world, and it is the most leading cause of death in both developed and developing countries; it’s also the most frequented cancer among middle age with estimated 1.38 million new cases diagnosed in 2011, (ACS, 2011). Early detection of breast cancer is based on the observation that treatment is more effective when the disease is detected earlier in its natural history, prior to development of symptoms, than in an advanced stage. However, According to National Cancer institute (2010). About 17% of Ugandan women go for breast cancer screening. The overall objective of this study was to identify influence of Andersen’s Model on utilization of breast cancer screening among university students in KIU, Kampala-Makindye Division Uganda. Methodology: A descriptive cross-sectional study design using structured and researcher-administered questionnaire was used to a sample size of 219 respondents. The study employed both Simple Random Sampling and convenient methods. Results: The study showed that only 50 (23.0%) had ever gone for breast cancer screening whereas majority of the participants had never gone for breast cancer screening. This shows that prevalence of breast cancer screening services is still low among the female students. Anderson’s Model factors including; age, marital status, religion, employment status, monthly household income, knowledge about the breast cancer screening facilities, perception about the breast cancer screenings, health insurance status, accessibility and afford ability of breast cancer screening were strongly associated with utilization of breast cancer screening among university students in KIU, Kampala-Makindye Division Uganda. Conclusion and Recommendation: The study showed prevalence of breast cancer screening services utilization is still low among the university students. Therefore the researcher recommends the following in order to improve the utilization of BCS: breast cancer screening education, promotion, provision of accessible and affordable breast cancer screening services and lastly more attention should be given to underrepresented groups, particularly those with low income, education and those with negative perception about the breast cancer screening services through health education campaigns.
Assesment of Acquisition Procedures for Medicines and Health Supplies From National Medical Stores by General and Regional Referal Health Facilities in Uganda.
(International Health Sciences University., 2014-11) Okello, George Ekwaro
Introduction This study was to assess the acquisition procedure of medicines and related supplies by public health facilities from National Medical Stores. The specific objectives were: 1. To assess the health facility ordering practices in relation to their procurement plan in FY 2013/14. 2. To determine order fulfillment rate of NMS against order made by health facilities. 3. To analyze the level of adherence of NMS to the published delivery schedule. 4. To assess the level of NMS Customer satisfaction with its service delivery. Methodology A retrospective survey was used with both qualitative and quantitative data collected from NMS and health facilities. Qualitative data was collected from key respondents who were facility in-charges, pharmacy in-charges or stores assistants while quantitative data collected from records such as health facility procurement plans and orders, delivery notes and NMS delivery schedules. Result The major findings were that RRHs ordered more medicines according to their procurement plans than GHs. Order fulfillment rate against orders made were highest at Mbale and Mityana hospitals and lowest at Abim. NMS adherence to the delivery schedule is at over 80 percent at RRHs and GHs. Level of NMS customer satisfaction with its services is over 80 percent. Recommendations MOH should train facilities in preparing procurement plans using Essential Medicines and health supplies list of Uganda and Uganda clinical guidelines. Thereafter, MOH should step up support supervision and mentoring to ensure all that facilities’ ordering practices are in relation to their procurement plans. NMS should improve its order fulfillment rate against orders by ensuring that all items ordered by facilities are served according to the orders. NMS should ensure that the level of adherence to its published delivery schedules is improved so that all orders are served by or before the delivery end date. NMS should hold regular meetings or dialogues with its customers and collectively come up with the best interventions for improving service delivery (and hence customer satisfaction) in health facilities. Further study should be done to establish other drivers of customer satisfaction than NMS adherence to delivery schedule and order fulfillment.
Assesment of Management Processes Influencing the Functionality of Rural Water Facilities:
(International Health Sciences University., 2014-11) Echodu, Tom Moses.
Introduction: Uganda's domestic water policy calls for sustainable provision of safe water within easy reach, and based on management responsibility and ownership by users with effective use and functionality of the water facilities. This is in-line with the Millennium Development Goal 7 (MDG 7) which has a target to reduce by half the proportion of people without access to safe drinking water and basic sanitation by 2015. The achievement of this goal is on track, but rural areas in developing countries across the world continue to remain severely disadvantaged with 780 million people not having access to an improved water supply. The challenge to rural water sustainability is highly recognized but it is jeopardizing the county's vision and the MDG achievements for safe water. For example only 2 out of 3 hand pumps installed in developing countries are working at a given point in time (RWSN 2010). Objective: The objective of this study was to investigate the management processes influencing functionality of rural water facilities in Koro sub-county, Gulu district, as no such study has been carried out before. The study aimed at establishing, the compliance level of water agencies to rural supply management guidelines, the capacity of water source committees and hand pump mechanics to manage safe water facilities, and level of contribution of water users towards functionality of rural water facilities. Method: This was a cross sectional study that involved 191 respondents who included water users, water user committees, and hand pump mechanics and water supply agencies. A total of 36 water sources were sampled comprising of 28 boreholes, 6 shallow wells and 2 protected springs. Data was collected by trained research assistants then entered in Epidata and exported to SPSS v16 for statistical analysis. The Pearson Chi-squared test was used to determine association between independent and the dependent variables. In all analysis, significance level of less than 5% was considered. Results: Boreholes had a functionality rate of 73.2%, and shallow wells a functionality rate of 83.3%, while protected springs had a functionality of 100%. The study shows that water users were contributing actively towards functionality of the water facility. 71.1% willing paid water user fees, 84.2%, selected water source committees, 89.4%, had set rules and regulations and 92.1% had attended meetings on management of water facilities. However 28.9% of water users were unwilling to pay water user fees and sited issues like lack of transparency and accountability In regards to the capacity of water source committees the findings show that 66.6% collect water user fees, 83.4% organize community meeting to address issues of water facilities, 88.9% mobilized community for routine cleaning, 89.9% reported defects on water facilities and 53.8% paid hand pump mechanics whenever they repaired water facilities. Loss of moral with time, lack of leadership skills, migration to other villages especially women when they are married, death and lack of refresher trainings were noted as gaps affecting performance of WSC. The ability of the hand pump mechanics to carry out maintenance is highly compromised by lack of skills in some key approaches especially fishing out fallen pipes and replacing plastic pipes. This is made worse by lack of tools as it was reported that only two tool kits are available for 6 hand pump mechanics. Water supply agencies are hardly complying with their mandate of providing support to community based service providers and often lack capabilities especially resources to perform this obligation Conclusion: To ensure that water sources continue to function, service providers, and water users need to be supported externally especially by local governments. For local governments to carry out their responsibilities as indicated in the guidelines they need to strengthen in terms of resources and capabilities otherwise indicators for measuring compliance of water supply agencies as regards to rural water supply need to be revised in the current existing water policies, operation and maintenance framework. Recommendations: The researcher recommends that there is need to; explore or develop accounting systems and ask community to adopt village savings and loan association (V SLA) or use sub county account to keep collected funds, equip care takers with skills, tools and equipment for maintenance, provide a monthly/ allowance for WSC/HPM, regularly reselect and train WSC, preferable after every 2 years, and make operations of WSC legal or formal, so that it is easy to monitor and control their work
Assess the Capacity of Health Centre IVs to Manage Mental Health Problems :
(International Health Sciences University, 2011-09) Vincent, Mujune
According to the Mental Health Gap Action Programme (MHGAP), mental disorders account for 14% of the global burden of disease; 75% of which are in Low Developed Countries (WHO, 2008). In Uganda, common mental disorders can be detected in 20% to 30% of all outpatient visits common in community health centres (Kigozi et al, 2005). Although it is recommended that majority of cases of mental health problems identified within community be recognized and treated within Community Health Centres, research by Holdaway (2003) shows that up to 50% of patients who present mental health problems fail to have their symptoms recognized by a general medical practitioner. The implications of this are many and present themselves in terms of human social cost and economic cost. The study assessed the capacity of Health Centres IVs to manage mental health problems as a basis for improved mental health service delivery within community Health centres in Uganda. The study uses a case study of Health Centre IVs in Wakiso district as a generalizeable study area representing urban, semi-urban and rural characteristics. The focus of this study is primarily on the capacity of Health Centre IVs, based on their jurisdiction as the main point of referral in each health sub district, to manage mental health problems. The objectives of the study were to identify existing forms of care available for mental health problems, to analyse the capacity of primary health care workers to effectively manage cases of mental health problems and to describe existing mechanisms for resourcing the treatment of mental health problems by 2011. A cross sectional study design was chosen as applied to the case study of Wakiso district. A total of 33 respondents were interviewed. The District Health Officer, Mental Health Focal Person, Psychiatric Clinical officers and Nurses were taken as purposive samples. The health care workers were drawn from Health Centres IVs including Buwambo, Kasangati, Namayumba, Ndejje and Wakiso. Findings show that clinical treatment of mental health problems was the primary form of care provided by 70% of the Health Care Workers followed by psychological care provided by 80.65% of which 75% use counseling as for delivering psychological services to patients. There was limited understanding of techniques such as Cognitive Behaviour Therapy (14.29%), Narrative Exposure Therapy (14.81%), Motivational Interviewing (18.52%) and Group Therapy Sessions (14.81%) which are important for the effectiveness of any counseling interventions. In spite the government effort to recruit Psychiatric Clinical Officers and Nurses on the staff teams at the five Health Centres, the findings show a high propensity for mental health referrals by approximately 89% of health care workers which contests the capacity of the health care workers to manage mental health problems. In addition, of the cases referred, 27.59% of them are made to the resident mental health specialist at each Health Centre IV which denoted limited involvement of general health care workers in treatment on mental health problems. The main source for resourcing mental health care is facilitated by the Government of Uganda with undocumented proportions of out of pocket expenditure by patients and care givers. Although it is evident that resources such psychotropic medicines are well stocked represented by 85% of all health care workers, constraints at the health centres are responsible for limited admissions, follow up and provision of psycho-education services to clients. In conclusion, although efforts have been made to improve the capacity of Health Centre IVs to manage mental health problems, it is important to integrate such efforts with quality control mechanism which can be done through establishment and implementation of effective monitoring and evaluation mechanisms.