TY - JOUR
T1 - Makerere University College of Health Sciences' role in addressing challenges in health service provision at Mulago National Referral Hospital
AU - Kizza, Irene B.
AU - Tugumisirize, Joshua
AU - Tweheyo, Raymond
AU - Mbabali, Speciosa
AU - Kasangaki, Arabat
AU - Nshimye, Edith
AU - Sekandi, Juliet
AU - Groves, Sara L
AU - Kennedy, Caitlin E.
N1 - Funding Information:
All of the authors of this study were funded by a grant from the Bill and Melinda Gates Foundation. IK participated in the conception and design of the study, participated in the data analysis, and led the drafting of the manuscript. JT participated in the conception and design of the study and data analysis and helped draft part of the manuscript. RT participated in the data analysis and helped draft part of the manuscript. AK participated in the design of the study and data analysis. SM and EN participated in the conception, design and data analysis. JS participated in the conception and design. SG and CK participated in data analysis and the draft of the manuscript. All authors read and approved the final manuscript.
Funding Information:
The team is grateful for the support of the Bill and Melinda Gates Foundation for funding this work through the “Partnership for Building the Capacity of Makerere University to Improve Health Outcomes in Uganda”, a Collaborative Learning Initiative with Johns Hopkins University (Grant # 49504). The authors would like to acknowledge the many individuals who made this research possible: Jennifer and Vincent Kawooya, for assisting with data collection; Lynn Atuyambe, who assisted with refining the qualitative research tools and information on qualitative analysis; Laura Bernard, who provided comments on an earlier draft of the manuscript; George Pariyo, David Peters, and David Serwadda, for providing strategic leadership, and the rest of the Gates MU-JHU twinning project team, for feedback throughout the process; and all faculty and staff members who participated in interviews and focus groups, in particular the Deputy Director of MNRH and the Principal of MakCHS. This article has been published as part of BMC International Health and Human Right Volume 11 Supplement 1, 2011: An innovative approach to building capacity at an African university to improve health outcomes. The full contents of the supplement are available online at http://www.biomedcentral.com/1472-698X/11?issue=S1.
PY - 2011
Y1 - 2011
N2 - Background: Mulago National Referral Hospital (MNRH), Uganda's primary tertiary and teaching hospital, and Makerere University College of Health Sciences (MakCHS) have a close collaborative relationship. MakCHS students complete clinical rotations at MNRH, and MakCHS faculty partner with Mulago staff in clinical care and research. In 2009, as part of a strategic planning process, MakCHS undertook a qualitative study to examine care and service provision at MNRH, identify challenges, gaps, and solutions, and explore how MakCHS could contribute to improving care and service delivery at MNRH. Methods. Key informant interviews (n=23) and focus group discussions (n=7) were conducted with nurses, doctors, administrators, clinical officers and other key stakeholders. Interviews and focus groups were tape recorded and transcribed verbatim, and findings were analyzed through collaborative thematic analysis. Results: Challenges to care and service delivery at MNRH included resource constraints (staff, space, equipment, and supplies), staff inadequacies (knowledge, motivation, and professionalism), overcrowding, a poorly functioning referral system, limited quality assurance, and a cumbersome procurement system. There were also insufficiencies in the teaching of professionalism and communication skills to students, and patient care challenges that included lack of access to specialized services, risk of infections, and inappropriate medications. Suggestions for how MakCHS could contribute to addressing these challenges included strengthening referral systems and peripheral health center capacity, and establishing quality assurance mechanisms. The College could also strengthen the teaching of professionalism, communication and leadership skills to students, and monitor student training and develop courses that contribute to continuous professional development. Additionally, the College could provide in-service education for providers on professionalism, communication skills, strategies that promote evidence-based practice and managerial leadership skills. Conclusions: Although there are numerous barriers to delivery of quality health services at MNRH, many barriers could be addressed by strengthening the relationship between the Hospital and MakCHS. Strategic partnerships and creative use of existing resources, both human and financial, could improve the quality of care and service delivery at MNRH. Improving services and providing more skills training could better prepare MakCHS graduates for leadership roles in other health care facilities, ultimately improving health outcomes throughout Uganda.
AB - Background: Mulago National Referral Hospital (MNRH), Uganda's primary tertiary and teaching hospital, and Makerere University College of Health Sciences (MakCHS) have a close collaborative relationship. MakCHS students complete clinical rotations at MNRH, and MakCHS faculty partner with Mulago staff in clinical care and research. In 2009, as part of a strategic planning process, MakCHS undertook a qualitative study to examine care and service provision at MNRH, identify challenges, gaps, and solutions, and explore how MakCHS could contribute to improving care and service delivery at MNRH. Methods. Key informant interviews (n=23) and focus group discussions (n=7) were conducted with nurses, doctors, administrators, clinical officers and other key stakeholders. Interviews and focus groups were tape recorded and transcribed verbatim, and findings were analyzed through collaborative thematic analysis. Results: Challenges to care and service delivery at MNRH included resource constraints (staff, space, equipment, and supplies), staff inadequacies (knowledge, motivation, and professionalism), overcrowding, a poorly functioning referral system, limited quality assurance, and a cumbersome procurement system. There were also insufficiencies in the teaching of professionalism and communication skills to students, and patient care challenges that included lack of access to specialized services, risk of infections, and inappropriate medications. Suggestions for how MakCHS could contribute to addressing these challenges included strengthening referral systems and peripheral health center capacity, and establishing quality assurance mechanisms. The College could also strengthen the teaching of professionalism, communication and leadership skills to students, and monitor student training and develop courses that contribute to continuous professional development. Additionally, the College could provide in-service education for providers on professionalism, communication skills, strategies that promote evidence-based practice and managerial leadership skills. Conclusions: Although there are numerous barriers to delivery of quality health services at MNRH, many barriers could be addressed by strengthening the relationship between the Hospital and MakCHS. Strategic partnerships and creative use of existing resources, both human and financial, could improve the quality of care and service delivery at MNRH. Improving services and providing more skills training could better prepare MakCHS graduates for leadership roles in other health care facilities, ultimately improving health outcomes throughout Uganda.
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U2 - 10.1186/1472-698X-11-S1-S7
DO - 10.1186/1472-698X-11-S1-S7
M3 - Article
C2 - 21411007
AN - SCOPUS:79952507693
VL - 11
JO - BMC Public Health
JF - BMC Public Health
SN - 1471-2458
IS - SUPPL. 1
M1 - S7
ER -