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Published in: BMC Health Services Research 1/2016

Open Access 01-12-2016 | Research article

Assessing the potential of rural and urban private facilities in implementing child health interventions in Mukono district, central Uganda–a cross sectional study

Authors: Elizeus Rutebemberwa, Esther Buregyeya, Sham Lal, Sîan E. Clarke, Kristian S. Hansen, Pascal Magnussen, Philip LaRussa, Anthony K. Mbonye

Published in: BMC Health Services Research | Issue 1/2016

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Abstract

Background

Private facilities are the first place of care seeking for many sick children. Involving these facilities in child health interventions may provide opportunities to improve child welfare. The objective of this study was to assess the potential of rural and urban private facilities in diagnostic capabilities, operations and human resource in the management of malaria, pneumonia and diarrhoea.

Methods

A survey was conducted in pharmacies, private clinics and drug shops in Mukono district in October 2014. An assessment was done on availability of diagnostic equipment for malaria, record keeping, essential drugs for the treatment of malaria, pneumonia and diarrhoea; the sex, level of education, professional and in-service training of the persons found attending to patients in these facilities. A comparison was made between urban and rural facilities. Univariate and bivariate analysis was done.

Results

A total of 241 private facilities were assessed with only 47 (19.5 %) being in rural areas. Compared to urban areas, rural private facilities were more likely to be drug shops (OR 2.80; 95 % CI 1.23–7.11), less likely to be registered (OR 0.31; 95 % CI 0.16–0.60), not have trained clinicians, less likely to have people with tertiary education (OR 0.34; 95 % CI 0.17–0.66) and less likely to have zinc tablets (OR 0.38; 95 % CI 0.19–0.78). In both urban and rural areas, there was low usage of stock cards and patient registers. About half of the facilities in both rural and urban areas attended to at least one sick child in the week prior to the interview.

Conclusion

There were big gaps between rural and urban private facilities with rural ones having less trained personnel and less zinc tablets’ availability. In both rural and urban areas, record keeping was low. Child health interventions need to build capacity of private facilities with special focus on rural areas where child mortality is higher and capacity of facilities lower.
Literature
1.
go back to reference Konde-Lule J, Gitta SN, Lindfors A, Okuonzi S, Onama VO, Forsberg BC. Private and public health care in rural areas of Uganda. BMC Int Health Hum Rights. 2010;10:29.CrossRefPubMedPubMedCentral Konde-Lule J, Gitta SN, Lindfors A, Okuonzi S, Onama VO, Forsberg BC. Private and public health care in rural areas of Uganda. BMC Int Health Hum Rights. 2010;10:29.CrossRefPubMedPubMedCentral
3.
go back to reference Deressa W, Ali A, Hailemariam D. Malaria-related health-seeking behaviour and challenges for care providers in rural Ethiopia: implications for control. J Biosoc Sci. 2008;40(1):115–35.CrossRefPubMed Deressa W, Ali A, Hailemariam D. Malaria-related health-seeking behaviour and challenges for care providers in rural Ethiopia: implications for control. J Biosoc Sci. 2008;40(1):115–35.CrossRefPubMed
4.
go back to reference Rutebemberwa E, Pariyo G, Peterson S, Tomson G, Kallander K. Utilization of public or private health care providers by febrile children after user fee removal in Uganda. Malar J. 2009;8(1):45.CrossRefPubMedPubMedCentral Rutebemberwa E, Pariyo G, Peterson S, Tomson G, Kallander K. Utilization of public or private health care providers by febrile children after user fee removal in Uganda. Malar J. 2009;8(1):45.CrossRefPubMedPubMedCentral
5.
go back to reference Nabyonga Orem J, Mugisha F, Okui AP, Musango L, Kirigia JM. Health care seeking patterns and determinants of out-of-pocket expenditure for Malaria for the children under-five in Uganda. Malar J. 2013;12:175.CrossRefPubMedPubMedCentral Nabyonga Orem J, Mugisha F, Okui AP, Musango L, Kirigia JM. Health care seeking patterns and determinants of out-of-pocket expenditure for Malaria for the children under-five in Uganda. Malar J. 2013;12:175.CrossRefPubMedPubMedCentral
6.
go back to reference Wafula FN, Goodman CA. Are interventions for improving the quality of services provided by specialized drug shops effective in sub-Saharan Africa? A systematic review of the literature. Int J Qual Health Care. 2010;22(4):316–23.CrossRefPubMedPubMedCentral Wafula FN, Goodman CA. Are interventions for improving the quality of services provided by specialized drug shops effective in sub-Saharan Africa? A systematic review of the literature. Int J Qual Health Care. 2010;22(4):316–23.CrossRefPubMedPubMedCentral
7.
go back to reference Awor P, Wamani H, Bwire G, Jagoe G, Peterson S. Private sector drug shops in integrated community case management of malaria, pneumonia, and diarrhea in children in Uganda. Am J Trop Med Hyg. 2012;87(5 Suppl):92–6.CrossRefPubMedPubMedCentral Awor P, Wamani H, Bwire G, Jagoe G, Peterson S. Private sector drug shops in integrated community case management of malaria, pneumonia, and diarrhea in children in Uganda. Am J Trop Med Hyg. 2012;87(5 Suppl):92–6.CrossRefPubMedPubMedCentral
8.
go back to reference Maiga FI, Haddad S, Fournier P, Gauvin L. Public and private sector responses to essential drugs policies: a multilevel analysis of drug prescription and selling practices in Mali. Soc Sci Med. 2003;57(5):937–48.CrossRefPubMed Maiga FI, Haddad S, Fournier P, Gauvin L. Public and private sector responses to essential drugs policies: a multilevel analysis of drug prescription and selling practices in Mali. Soc Sci Med. 2003;57(5):937–48.CrossRefPubMed
9.
go back to reference Mills A, Brugha R, Hanson K, McPake B. What can be done about the private health sector in low-income countries? Bull World Health Organ. 2002;80(4):325–30.PubMedPubMedCentral Mills A, Brugha R, Hanson K, McPake B. What can be done about the private health sector in low-income countries? Bull World Health Organ. 2002;80(4):325–30.PubMedPubMedCentral
10.
go back to reference Tawfik Y, Northrup R, Prysor-Jones S. Utilizing the Potential of Formal and Informal Private Practioners in Child Survival: Situation Analysis and Summary of Promising Interventions. Washington DC: USAID, Bureau for Africa, Office of Sustainable Development; 2002. Tawfik Y, Northrup R, Prysor-Jones S. Utilizing the Potential of Formal and Informal Private Practioners in Child Survival: Situation Analysis and Summary of Promising Interventions. Washington DC: USAID, Bureau for Africa, Office of Sustainable Development; 2002.
11.
go back to reference Morris A, Ward A, Moonen B, Sabot O, Cohen JM. Price subsidies increase the use of private sector ACTs: evidence from a systematic review. Health Policy Plan. 2015;30(3):397–405.CrossRefPubMed Morris A, Ward A, Moonen B, Sabot O, Cohen JM. Price subsidies increase the use of private sector ACTs: evidence from a systematic review. Health Policy Plan. 2015;30(3):397–405.CrossRefPubMed
12.
go back to reference Rutebemberwa E, Kadobera D, Katureebe S, Kalyango JN, Mworozi E, Pariyo G. Use of community health workers for management of malaria and pneumonia in urban and rural areas in eastern Uganda. Am J Trop Med Hyg. 2012;87(5 Suppl):30–5.CrossRefPubMedPubMedCentral Rutebemberwa E, Kadobera D, Katureebe S, Kalyango JN, Mworozi E, Pariyo G. Use of community health workers for management of malaria and pneumonia in urban and rural areas in eastern Uganda. Am J Trop Med Hyg. 2012;87(5 Suppl):30–5.CrossRefPubMedPubMedCentral
13.
go back to reference Uganda Bureau of Statistics. Statistical Abstract. Kampala: Uganda Bureau of Statistics; 2014. Uganda Bureau of Statistics. Statistical Abstract. Kampala: Uganda Bureau of Statistics; 2014.
14.
go back to reference Mukono District Administration. Mukono Five year Development Plan 2010–2015. Mukono: Mukono Local Government; 2010 Mukono District Administration. Mukono Five year Development Plan 2010–2015. Mukono: Mukono Local Government; 2010
15.
go back to reference Tawfik Y, Nsungwa-Sabitii J, Greer G, Owor J, Kesande R, Prysor-Jones S. Negotiating improved case management of childhood illness with formal and informal private practitioners in Uganda. Trop Med Int Health. 2006;11(6):967–73.CrossRefPubMed Tawfik Y, Nsungwa-Sabitii J, Greer G, Owor J, Kesande R, Prysor-Jones S. Negotiating improved case management of childhood illness with formal and informal private practitioners in Uganda. Trop Med Int Health. 2006;11(6):967–73.CrossRefPubMed
16.
go back to reference Konde-Lule J, Okuonzi S, Matsiko C, Mukanga D, Onama V, Gitta S. N. The Potential of the Private sector to improve health outcomes in Uganda. Kampala: Makerere University Institute of Public Health; 2006. Konde-Lule J, Okuonzi S, Matsiko C, Mukanga D, Onama V, Gitta S. N. The Potential of the Private sector to improve health outcomes in Uganda. Kampala: Makerere University Institute of Public Health; 2006.
17.
go back to reference Population secretariat. The State of Uganda Population Report 2014. Kampala: Ministry of Finance, Planning and Economic Development; 2014. Population secretariat. The State of Uganda Population Report 2014. Kampala: Ministry of Finance, Planning and Economic Development; 2014.
18.
go back to reference Tumwikirize WA, Ekwaru PJ, Mohammed K, Ogwal-Okeng JW, Aupont O. Management of acute respiratory infections in drug shops and private pharmacies in Uganda: a study of counter attendants’ knowledge and reported behaviour. East Afr Med J. 2004;Suppl:S33-40. Tumwikirize WA, Ekwaru PJ, Mohammed K, Ogwal-Okeng JW, Aupont O. Management of acute respiratory infections in drug shops and private pharmacies in Uganda: a study of counter attendants’ knowledge and reported behaviour. East Afr Med J. 2004;Suppl:S33-40.
19.
go back to reference Perin J, Carvajal-Velez L, Carter E, Bryce J, Newby H. Fluid curtailment during childhood diarrhea: a countdown analysis. BMC Public Health. 2015;15:588.CrossRefPubMedPubMedCentral Perin J, Carvajal-Velez L, Carter E, Bryce J, Newby H. Fluid curtailment during childhood diarrhea: a countdown analysis. BMC Public Health. 2015;15:588.CrossRefPubMedPubMedCentral
20.
go back to reference Rutebemberwa E, Nsabagasani X, Pariyo G, Tomson G, Peterson S, Kallander K. Use of drugs, perceived drug efficacy and preferred providers for febrile children: implications for home management of fever. Malar J. 2009;8(1):131.CrossRefPubMedPubMedCentral Rutebemberwa E, Nsabagasani X, Pariyo G, Tomson G, Peterson S, Kallander K. Use of drugs, perceived drug efficacy and preferred providers for febrile children: implications for home management of fever. Malar J. 2009;8(1):131.CrossRefPubMedPubMedCentral
21.
go back to reference World Health Organization. Guidelines for the treatment of malaria. Thirdth ed. Geneva: World Health Organization; 2015. World Health Organization. Guidelines for the treatment of malaria. Thirdth ed. Geneva: World Health Organization; 2015.
22.
go back to reference Kung’u JK, Owolabi O, Essien G, Aminu FT, Ngnie-Teta I, Neufeld LM. Promotion of zinc tablets with ORS through child health weeks improves caregiver knowledge, attitudes, and practice on treatment of diarrhoea in Nigeria. J Health Popul Nutr. 2015;33(1):9–19.CrossRefPubMedPubMedCentral Kung’u JK, Owolabi O, Essien G, Aminu FT, Ngnie-Teta I, Neufeld LM. Promotion of zinc tablets with ORS through child health weeks improves caregiver knowledge, attitudes, and practice on treatment of diarrhoea in Nigeria. J Health Popul Nutr. 2015;33(1):9–19.CrossRefPubMedPubMedCentral
23.
go back to reference Akpede GO, Omotara BA, Webb GD, Igene JO. Caretakers’ knowledge and preparation abilities of salt-sugar solution in north-eastern Nigeria. J Diarrhoeal Dis Res. 1997;15(4):232–40.PubMed Akpede GO, Omotara BA, Webb GD, Igene JO. Caretakers’ knowledge and preparation abilities of salt-sugar solution in north-eastern Nigeria. J Diarrhoeal Dis Res. 1997;15(4):232–40.PubMed
Metadata
Title
Assessing the potential of rural and urban private facilities in implementing child health interventions in Mukono district, central Uganda–a cross sectional study
Authors
Elizeus Rutebemberwa
Esther Buregyeya
Sham Lal
Sîan E. Clarke
Kristian S. Hansen
Pascal Magnussen
Philip LaRussa
Anthony K. Mbonye
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2016
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-016-1529-9

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