Examining the Ugandan health system's readiness to deliver rheumatic heart disease-related services.
Background In 2018, the World Health Assembly mandated Member States to take action on rheumatic heart disease (RHD), which persists in countries with weak health systems. We conducted an assessment of the current state of RHD-related healthcare in Uganda. Methodology/principal findings This was a m...
Published in: | PLOS Neglected Tropical Diseases |
---|---|
Main Authors: | , , , , , , , , , , , , , |
Format: | Article in Journal/Newspaper |
Language: | English |
Published: |
Public Library of Science (PLoS)
2021
|
Subjects: | |
Online Access: | https://doi.org/10.1371/journal.pntd.0009164 https://doaj.org/article/47534d4ea9ec42a786083036ed3a7fdf |
id |
ftdoajarticles:oai:doaj.org/article:47534d4ea9ec42a786083036ed3a7fdf |
---|---|
record_format |
openpolar |
spelling |
ftdoajarticles:oai:doaj.org/article:47534d4ea9ec42a786083036ed3a7fdf 2023-05-15T15:12:24+02:00 Examining the Ugandan health system's readiness to deliver rheumatic heart disease-related services. Emma Ndagire Yoshito Kawakatsu Hadija Nalubwama Jenifer Atala Rachel Sarnacki Jafesi Pulle Rakeli Kyarimpa Rachel Mwima Rosemary Kansiime Emmy Okello Peter Lwabi Andrea Beaton Craig Sable David Watkins 2021-02-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0009164 https://doaj.org/article/47534d4ea9ec42a786083036ed3a7fdf EN eng Public Library of Science (PLoS) https://doi.org/10.1371/journal.pntd.0009164 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0009164 https://doaj.org/article/47534d4ea9ec42a786083036ed3a7fdf PLoS Neglected Tropical Diseases, Vol 15, Iss 2, p e0009164 (2021) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2021 ftdoajarticles https://doi.org/10.1371/journal.pntd.0009164 2022-12-31T07:49:52Z Background In 2018, the World Health Assembly mandated Member States to take action on rheumatic heart disease (RHD), which persists in countries with weak health systems. We conducted an assessment of the current state of RHD-related healthcare in Uganda. Methodology/principal findings This was a mixed-methods, deductive simultaneous design study conducted in four districts of Uganda. Using census sampling, we surveyed health facilities in each district using an RHD survey instrument that was modeled after the WHO SARA tool. We interviewed health workers with experience managing RHD, purposively sampling to ensure a range of qualification and geographic variation. Our final sample included 402 facilities and 36 health workers. We found major gaps in knowledge of clinical guidelines and availability of diagnostic tests. Antibiotics used in RHD prevention were widely available, but cardiovascular medications were scarce. Higher levels of service readiness were found among facilities in the western region (Mbarara district) and private facilities. Level III health centers were the most prepared for delivering secondary prevention. Health worker interviews revealed that limited awareness of RHD at the district level, lack of diagnostic tests and case management registries, and absence of clearly articulated RHD policies and budget prioritization were the main barriers to providing RHD-related healthcare. Conclusions/significance Uganda's readiness to implement the World Health Assembly RHD Resolution is low. The forthcoming national RHD strategy must focus on decentralizing RHD diagnosis and prevention to the district level, emphasizing specialized training of the primary healthcare workforce and strengthening supply chains of diagnostics and essential medicines. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 15 2 e0009164 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
spellingShingle |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Emma Ndagire Yoshito Kawakatsu Hadija Nalubwama Jenifer Atala Rachel Sarnacki Jafesi Pulle Rakeli Kyarimpa Rachel Mwima Rosemary Kansiime Emmy Okello Peter Lwabi Andrea Beaton Craig Sable David Watkins Examining the Ugandan health system's readiness to deliver rheumatic heart disease-related services. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
Background In 2018, the World Health Assembly mandated Member States to take action on rheumatic heart disease (RHD), which persists in countries with weak health systems. We conducted an assessment of the current state of RHD-related healthcare in Uganda. Methodology/principal findings This was a mixed-methods, deductive simultaneous design study conducted in four districts of Uganda. Using census sampling, we surveyed health facilities in each district using an RHD survey instrument that was modeled after the WHO SARA tool. We interviewed health workers with experience managing RHD, purposively sampling to ensure a range of qualification and geographic variation. Our final sample included 402 facilities and 36 health workers. We found major gaps in knowledge of clinical guidelines and availability of diagnostic tests. Antibiotics used in RHD prevention were widely available, but cardiovascular medications were scarce. Higher levels of service readiness were found among facilities in the western region (Mbarara district) and private facilities. Level III health centers were the most prepared for delivering secondary prevention. Health worker interviews revealed that limited awareness of RHD at the district level, lack of diagnostic tests and case management registries, and absence of clearly articulated RHD policies and budget prioritization were the main barriers to providing RHD-related healthcare. Conclusions/significance Uganda's readiness to implement the World Health Assembly RHD Resolution is low. The forthcoming national RHD strategy must focus on decentralizing RHD diagnosis and prevention to the district level, emphasizing specialized training of the primary healthcare workforce and strengthening supply chains of diagnostics and essential medicines. |
format |
Article in Journal/Newspaper |
author |
Emma Ndagire Yoshito Kawakatsu Hadija Nalubwama Jenifer Atala Rachel Sarnacki Jafesi Pulle Rakeli Kyarimpa Rachel Mwima Rosemary Kansiime Emmy Okello Peter Lwabi Andrea Beaton Craig Sable David Watkins |
author_facet |
Emma Ndagire Yoshito Kawakatsu Hadija Nalubwama Jenifer Atala Rachel Sarnacki Jafesi Pulle Rakeli Kyarimpa Rachel Mwima Rosemary Kansiime Emmy Okello Peter Lwabi Andrea Beaton Craig Sable David Watkins |
author_sort |
Emma Ndagire |
title |
Examining the Ugandan health system's readiness to deliver rheumatic heart disease-related services. |
title_short |
Examining the Ugandan health system's readiness to deliver rheumatic heart disease-related services. |
title_full |
Examining the Ugandan health system's readiness to deliver rheumatic heart disease-related services. |
title_fullStr |
Examining the Ugandan health system's readiness to deliver rheumatic heart disease-related services. |
title_full_unstemmed |
Examining the Ugandan health system's readiness to deliver rheumatic heart disease-related services. |
title_sort |
examining the ugandan health system's readiness to deliver rheumatic heart disease-related services. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2021 |
url |
https://doi.org/10.1371/journal.pntd.0009164 https://doaj.org/article/47534d4ea9ec42a786083036ed3a7fdf |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 15, Iss 2, p e0009164 (2021) |
op_relation |
https://doi.org/10.1371/journal.pntd.0009164 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0009164 https://doaj.org/article/47534d4ea9ec42a786083036ed3a7fdf |
op_doi |
https://doi.org/10.1371/journal.pntd.0009164 |
container_title |
PLOS Neglected Tropical Diseases |
container_volume |
15 |
container_issue |
2 |
container_start_page |
e0009164 |
_version_ |
1766343089083908096 |