Comparison of the capacity between public and private health facilities to manage under-five children with febrile illnesses in Uganda
Research output: Contribution to journal › Journal article › Research › peer-review
Standard
Comparison of the capacity between public and private health facilities to manage under-five children with febrile illnesses in Uganda. / Buregyeya, Esther; Rutebemberwa, Elizeus; LaRussa, Phillip; Lal, Sham; Clarke, Sîan E.; Hansen, Kristian S.; Magnussen, Pascal; Mbonye, Anthony K.
In: Malaria Journal, Vol. 16, No. 1, 183, 2017.Research output: Contribution to journal › Journal article › Research › peer-review
Harvard
APA
Vancouver
Author
Bibtex
}
RIS
TY - JOUR
T1 - Comparison of the capacity between public and private health facilities to manage under-five children with febrile illnesses in Uganda
AU - Buregyeya, Esther
AU - Rutebemberwa, Elizeus
AU - LaRussa, Phillip
AU - Lal, Sham
AU - Clarke, Sîan E.
AU - Hansen, Kristian S.
AU - Magnussen, Pascal
AU - Mbonye, Anthony K.
PY - 2017
Y1 - 2017
N2 - Background: Public health facilities are usually the first to receive interventions compared to private facilities, yet majority of health seeking care is first done with the latter. This study compared the capacity to manage acute febrile illnesses in children below 5 years in private vs public health facilities in order to design interventions to improve quality of care. Methods: A survey was conducted within 57 geographical areas (parishes), from August to October 2014 in Mukono district, central Uganda. The survey comprised both facility and health worker assessment. Data were collected on drug stocks, availability of treatment guidelines, diagnostic equipment, and knowledge in management of malaria, pneumonia and diarrhoea, using a structured questionnaire. Results: A total of 53 public and 241 private health facilities participated in the study. While similar proportions of private and public health facilities stocked Coartem, the first-line anti-malarial drug, (98 vs 95%, p = 0.22), significantly more private than public health facilities stocked quinine (85 vs 53%, p < 0.01). Stocks of obsolete anti-malarial drugs, such as chloroquine, were reported in few public and private facilities (3.7 vs 12.5%, p = 0.06). Stocks of antibiotics-amoxycillin and gentamycin were similar in both sectors (≥90% for amoxicillin; ≥50 for gentamycin). Training in malaria was reported by 65% of public health facilities vs 56% in the private sector, p = 0.25), while, only 21% in the public facility and 12% in the private facilities, p = 0.11, reported receiving training in pneumonia. Only 55% of public facilities had microscopes. Malaria treatment guidelines were significantly lacking in the private sector, p = 0.01. Knowledge about first-line management of uncomplicated malaria, pneumonia and diarrhoea was significantly better in the public facilities compared to the private ones, though still sub-optimal. Conclusion: Deficiencies of equipment, supplies and training exist even in public health facilities. In order to significantly improve the capacity to handle acute febrile illness among children under five, training in proper case management, availability of supplies and diagnostics need to be addressed in both sectors.
AB - Background: Public health facilities are usually the first to receive interventions compared to private facilities, yet majority of health seeking care is first done with the latter. This study compared the capacity to manage acute febrile illnesses in children below 5 years in private vs public health facilities in order to design interventions to improve quality of care. Methods: A survey was conducted within 57 geographical areas (parishes), from August to October 2014 in Mukono district, central Uganda. The survey comprised both facility and health worker assessment. Data were collected on drug stocks, availability of treatment guidelines, diagnostic equipment, and knowledge in management of malaria, pneumonia and diarrhoea, using a structured questionnaire. Results: A total of 53 public and 241 private health facilities participated in the study. While similar proportions of private and public health facilities stocked Coartem, the first-line anti-malarial drug, (98 vs 95%, p = 0.22), significantly more private than public health facilities stocked quinine (85 vs 53%, p < 0.01). Stocks of obsolete anti-malarial drugs, such as chloroquine, were reported in few public and private facilities (3.7 vs 12.5%, p = 0.06). Stocks of antibiotics-amoxycillin and gentamycin were similar in both sectors (≥90% for amoxicillin; ≥50 for gentamycin). Training in malaria was reported by 65% of public health facilities vs 56% in the private sector, p = 0.25), while, only 21% in the public facility and 12% in the private facilities, p = 0.11, reported receiving training in pneumonia. Only 55% of public facilities had microscopes. Malaria treatment guidelines were significantly lacking in the private sector, p = 0.01. Knowledge about first-line management of uncomplicated malaria, pneumonia and diarrhoea was significantly better in the public facilities compared to the private ones, though still sub-optimal. Conclusion: Deficiencies of equipment, supplies and training exist even in public health facilities. In order to significantly improve the capacity to handle acute febrile illness among children under five, training in proper case management, availability of supplies and diagnostics need to be addressed in both sectors.
KW - Comparison
KW - Diarrhoea
KW - Malaria
KW - Management of febrile children
KW - Pneumonia
KW - Private sector
KW - Public health facilities
KW - Uganda
KW - Under-five children
U2 - 10.1186/s12936-017-1842-8
DO - 10.1186/s12936-017-1842-8
M3 - Journal article
C2 - 28464890
AN - SCOPUS:85018277996
VL - 16
JO - Malaria Journal
JF - Malaria Journal
SN - 1475-2875
IS - 1
M1 - 183
ER -
ID: 184390900