A case study on the quality of healthcare in Uganda: Examining the effectiveness, safety, patient-centred and timeliness of district healthcare facilities

https://doi.org/10.35912/jgas.v1i2.741
Published: Aug 2, 2021

Abstract:

Purpose: This study aims to examine the quality of healthcare in Uganda in terms of effectiveness, safety, patient-centred and timeliness of District Healthcare Facilities.

Research methodology: This study took a case study design involving an intensive, descriptive, and holistic analysis of PHFs in the Hoima district. Case study research involves studying a single entity in depth so as to understand the larger cases; to describe and explain rather than predict.

Results: The main factors affecting the quality of healthcare were; National health system, overall working environment, national budgetary allocation to the health sector, and collaboration between health centres and hospitals. Enhancing the quality of healthcare requires addressing the aforesaid as well as engaging with the LLGAs.

Limitations: This study only covers one district local government in a country where there are over 100 districts hence limiting the notion of generalization of results.

Contribution: This study contributes to understanding health-related issues from the perspective of quality, which is very key in health service delivery.

Keywords:
1. Healthcare
2. Effectiveness
3. Safety
4. Patient-centeredness
5. Timeliness
Authors:
1 . David Mwesigwa
Department of Public Administration and Management, Faculty of Management Sciences, Lira University, Lira, Uganda
2 . Khalid Abdul Wahid
Faculty of Information Management, Universiti Teknologi MARA Kelantan Branch, Kelantan, Malaysia
3 . Nipon Sohheng
Faculty of Political Sciences, Ramkhamheang University, Bangkok, Thailand
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How to Cite
Mwesigwa, D., Wahid, K. A., & Sohheng, N. (2021). A case study on the quality of healthcare in Uganda: Examining the effectiveness, safety, patient-centred and timeliness of district healthcare facilities. Journal of Governance and Accountability Studies, 1(2), 133–144. https://doi.org/10.35912/jgas.v1i2.741
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Issue & Section
Vol. 1 No. 2 (2021): July
Articles
References

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    Aceng, J.R. (2021). Health sector: Ministerial statement – financial year 2020/2021, MOH, Kampala.

    Assaf, M. (2020). A new experience of online education under the COVID-19 pandemic for occupational therapy students in Palestine. World federation for occupational therapists bulletin, 76(2):103-7. Doi: 10.1080/14473828.2020.1825274

    Bahendeka, S., Mutungi, G., Tugumisirize, F., Kamugisha, A., Nyangabyaki, C., Wesonga, R., Sseguya, W., Mubangizi, D., Nalunkuma, C., and Piloya, T. (2019). Healthcare delivery for paediatric and adolescent diabetes in low resource settings: type 1 diabetes clinics in Uganda. Global public health, 14(12):1869-83. Doi: 10.1080/17441692.2019.1611897

    Barton, S.J., Sandhu, S., Doan, I., Blanchard, L., Dai, A., Paulenich, A., Smith, E.R., Van de Water, B.J., Martin, A.H., Seider, J., Namaganda, F., Opolot, S., Ekeji, N., Bility, M.M., and Bettger, J.P. (2019). Perceived barriers and supports to accessing community-based services for Uganda’s paediatric post-surgical population. Disability and rehabilitation, doi: 10.1080/09638288.2019.1694999

    Brennan, E., and Abimbola, S. (2020). Understanding and progressing health system decentralisation in Myanmar. Global security: health, science and policy, 5(1):17-27. Doi: 10.1080/23779497.2020.1782247

    Cai, H., Zilm, F., Sheward, H., and Graham, K. (2020). Responding to COVID-19: healthcare surge capacity design for high-consequence infectious disease. Technology/architecture +design, 4(2):135-9. Doi: 10.1080/24751448.2020.1804752

    Essue, B.M., and Kapiriri, L. (2020). Priority setting for health system strengthening in low income countries: a qualitative case study illustrating the complexities. Health systems, doi: 10.1080/20476965.2020.1758596

    Fairchild, A., Gostin, L., and Bayer, R. (2020). Vexing, veiled, and inequitable: social distancing and the ‘Rights’ divide in the age of COVID-19. The American journal of bioethics, 20(7):55-61. Doi: 10.1080/15265161.2020.1764142

    Gliem, J. A., & Gliem, R. R. (2003). Calculating, interpreting, and reporting Cronbach’s alpha reliability coefficient for Likert-type scales. Midwest Research-to-Practice Conference in Adult, Continuing, and Community Education.

    Gomez-Degado, F., Katsiki, N., Lopez-Miranda, J., and Perez-Martinez, P. (2020). Dietary habits, lipoprotein metabolism and cardiovascular disease: from individual foods to dietary patterns. Critical reviews in food science and nutrition. Doi: 10.1080/10408398.2020.1764487

    Imlawi, J., and Gregg, D. (2020). Understanding the satisfaction and continuance intention of knowledge contribution by health professionals in online health communities. Informants for health and social care, 45(2):151-67. Doi: 10.1080/17538157.2019.1625053

    Jaja, I.F., Anyanwu, M.U., and Iwu Jaja, C. (2020). Social distancing: how religion, culture and burial ceremony undermine the effort to curb COVID-19 in South Africa. Emerging microbes & infections, 9(1):1077-9. Doi: 10.1080/22221751.2020.1769501

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    Jayantkumar, P.H., and Dasharathbhai, P.N. (2019). Study on patient satisfaction of outpatient department in ESI hospitals at Ahmedabad, Vadodara, and Surat in state of Gujarat. International journal of healthcare management, 12(4):259-64. Doi: 10.1080/20479700.2017.1398441

    Jillian, O., and Kizito, O. (2020). Socio-cultural factors associated with incomplete routine immunisation of children-Amach sub-county, Uganda. Cogent medicine, 7(1). Doi: 10.1080/2331205X.2020.1848755

    Kwateng, K.O., Lumor, R., and Acheampong, F.O. (2019). Service quality in public and private hospitals: a comparative study on patient satisfaction. International journal of healthcare management, 12(4):251-8. Doi: 10.1080/20479700.2017.1390183

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    Morgan, A.K. (2020). Making COVID-19 prevention etiquette of social distancing a reality for the homeless and slum dwellers in Ghana: lessons for consideration. Local environment, 25(7):536-39. Doi:10.1080/13549839.2020.1789854

    Mu, Y., Bossink, B., and Vinig, T. (2019). Service innovation quality in healthcare: service innovativeness and organisational renewal as driving forces. Total quality management & business excellence, 30(11&12):1219-34. Doi: 10.1080/14783363.2017.1362954

    O’Donovan, J., Hamala, R., Namanda, A.S., Musoke, D., Ssemugabo, C., and Winters, N. (2020). ‘We are the people whose opinions don’t matter’: a photo voice study exploring challenges faced by community health workers in Uganda. Global public health, 15(3):384-401. Doi: 10.1080/17441692.2019.1663233

    Okpala, P. (2020). Increasing access to quality healthcare through collaborative leadership. International journal of healthcare management, 13(3): 229-35. Doi: 10.1080/20479700.2017.1401276

    Omona, K., and Namuli, W., (2020). Factors influencing utilisation of intra-uterine device among postpartum mothers at Gombe hospital, Butambala district, Uganda. Cogent medicine, 7(1). Doi: 10.1080/2331205X.2020.1846264

    Rahman, S.Y. (2020). ‘Social distancing’ during COVID-19: the metaphors and politics of pandemic response in India. Health sociology review, 29(2):131-39. Doi: 10.1080/14461242.2020.1790404

    Richter, J.P., and Kazley, A.S. (2020). Social media: How hospital Facebook activity may influence patient satisfaction. Health marketing quarterly, 37(1):1-9. Doi: 10.1080/07359683.2020.1713573

    Ronca, E., Svheel-Sailer, A., Koch, H.G., Essig, S., Brah, M., Munzel, N., Gemperli, A., and swiSCI study group (2020). Satisfaction with access and quality of healthcare services for people with spinal cord injury living in the community. The journal of spinal cord medicine, 43(1):111-21. Doi: 10.1080/10790268.2018.1486623

    Simmons, A.L. (2020). COVID-19 social distancing: A snippet view of the autistic social world. Disability & society, 35(6):1007-11. Doi: 10.1080/09687599.2020.1774866

    Suleri, J. (2020). Learners’ experience and expectations during and post COVID-19 in higher education. Research in hospitality management, 10(2):91-9. Doi: 10.1080/22243534.2020.1869463

    Thuy, H.T., Ha, D.T., Tuong, P.V., Thinh, C.Q., and Nga, N.T. (2020). Availability of essential medicines in primary healthcare in Vietnam. International journal of healthcare management. Doi: 10.1080/20479700.2020.1756093

    Varea, V., and Gonzalez-Calvo, G. (2020). Touchless classes and absent bodies: teaching physical education in times of covid-19. Sport, education and society. Doi: 10.1080/13573322.2020.1791814

    Walcott, R.L., Ingels, J.B., Corso, P.S., Zalwango, S., Whalen, C.C., and Sekandi, J.N. (2020). There’s no such thing as a free TB diagnosis: catastrophic TB costs in urban Uganda. Global public health, 15(6): 877-88. Doi: 10.1080/17441692.2020.1724313

    Wasdani, K.P., and Prasad, A. (2020). The impossibility of social distancing among the urban poor: the case of an Indian slum in the times of COVID-19. Local environment, 25(5):414-8. Doi: 10.1080/13549839.2020.1754375

    World health organisation. (2016). Public financing for health in Africa: from Abuja to the SDGs. Health financing toward UHC.

    Wright, C. (2020). Local government fighting COVID-19. The round table, 109(3):338-9. Doi: 10.1080/00358533.2020.1763017

    Xie, X., Siau, K., and Nah, F.F. (2020). COVID-19 pandemic-online education in the new normal and the next normal. Journal of information technology case and application research, 22(3):175-87. Doi: 10.1080/15228053.2020.1824884

  1. Abiodun, A.J., and Adeyemi, K.S. (2020). Performance role models among public health facilities: an application of data envelopment analysis. International journal of healthcare management, 13(3):193-200. Doi: 10.1080/20479700.2017.1397379
  2. Aceng, J.R. (2021). Health sector: Ministerial statement – financial year 2020/2021, MOH, Kampala.
  3. Assaf, M. (2020). A new experience of online education under the COVID-19 pandemic for occupational therapy students in Palestine. World federation for occupational therapists bulletin, 76(2):103-7. Doi: 10.1080/14473828.2020.1825274
  4. Bahendeka, S., Mutungi, G., Tugumisirize, F., Kamugisha, A., Nyangabyaki, C., Wesonga, R., Sseguya, W., Mubangizi, D., Nalunkuma, C., and Piloya, T. (2019). Healthcare delivery for paediatric and adolescent diabetes in low resource settings: type 1 diabetes clinics in Uganda. Global public health, 14(12):1869-83. Doi: 10.1080/17441692.2019.1611897
  5. Barton, S.J., Sandhu, S., Doan, I., Blanchard, L., Dai, A., Paulenich, A., Smith, E.R., Van de Water, B.J., Martin, A.H., Seider, J., Namaganda, F., Opolot, S., Ekeji, N., Bility, M.M., and Bettger, J.P. (2019). Perceived barriers and supports to accessing community-based services for Uganda’s paediatric post-surgical population. Disability and rehabilitation, doi: 10.1080/09638288.2019.1694999
  6. Brennan, E., and Abimbola, S. (2020). Understanding and progressing health system decentralisation in Myanmar. Global security: health, science and policy, 5(1):17-27. Doi: 10.1080/23779497.2020.1782247
  7. Cai, H., Zilm, F., Sheward, H., and Graham, K. (2020). Responding to COVID-19: healthcare surge capacity design for high-consequence infectious disease. Technology/architecture +design, 4(2):135-9. Doi: 10.1080/24751448.2020.1804752
  8. Essue, B.M., and Kapiriri, L. (2020). Priority setting for health system strengthening in low income countries: a qualitative case study illustrating the complexities. Health systems, doi: 10.1080/20476965.2020.1758596
  9. Fairchild, A., Gostin, L., and Bayer, R. (2020). Vexing, veiled, and inequitable: social distancing and the ‘Rights’ divide in the age of COVID-19. The American journal of bioethics, 20(7):55-61. Doi: 10.1080/15265161.2020.1764142
  10. Gliem, J. A., & Gliem, R. R. (2003). Calculating, interpreting, and reporting Cronbach’s alpha reliability coefficient for Likert-type scales. Midwest Research-to-Practice Conference in Adult, Continuing, and Community Education.
  11. Gomez-Degado, F., Katsiki, N., Lopez-Miranda, J., and Perez-Martinez, P. (2020). Dietary habits, lipoprotein metabolism and cardiovascular disease: from individual foods to dietary patterns. Critical reviews in food science and nutrition. Doi: 10.1080/10408398.2020.1764487
  12. Imlawi, J., and Gregg, D. (2020). Understanding the satisfaction and continuance intention of knowledge contribution by health professionals in online health communities. Informants for health and social care, 45(2):151-67. Doi: 10.1080/17538157.2019.1625053
  13. Jaja, I.F., Anyanwu, M.U., and Iwu Jaja, C. (2020). Social distancing: how religion, culture and burial ceremony undermine the effort to curb COVID-19 in South Africa. Emerging microbes & infections, 9(1):1077-9. Doi: 10.1080/22221751.2020.1769501
  14. Jaspal, R., Lopez, B., and Lopez, P. (2020). Predicting social distancing and compulsive buying behaviours in response to COVID-19 in a United Kingdom sample. Cogent psychology, 7(1). Doi: 10.1080/23311908.2020.1800924
  15. Jayantkumar, P.H., and Dasharathbhai, P.N. (2019). Study on patient satisfaction of outpatient department in ESI hospitals at Ahmedabad, Vadodara, and Surat in state of Gujarat. International journal of healthcare management, 12(4):259-64. Doi: 10.1080/20479700.2017.1398441
  16. Jillian, O., and Kizito, O. (2020). Socio-cultural factors associated with incomplete routine immunisation of children-Amach sub-county, Uganda. Cogent medicine, 7(1). Doi: 10.1080/2331205X.2020.1848755
  17. Kwateng, K.O., Lumor, R., and Acheampong, F.O. (2019). Service quality in public and private hospitals: a comparative study on patient satisfaction. International journal of healthcare management, 12(4):251-8. Doi: 10.1080/20479700.2017.1390183
  18. Leonce, T.E. (2020). A dynamic model of quality assurance in primary healthcare in developing countries. International journal of healthcare management. Doi: 10.1080/20479700.2020.1756110
  19. Morais De Sousa, K., Pinhanez, M.M.S., Aguiar Do Monte, P., and Diniz, J.A. (2020). Salary, financial autonomy and efficiency of healthcare systems in local governments. Applied economics letters, 27(2):122-6. Doi: 10.1080/13504851.2019.1610697
  20. Morgan, A.K. (2020). Making COVID-19 prevention etiquette of social distancing a reality for the homeless and slum dwellers in Ghana: lessons for consideration. Local environment, 25(7):536-39. Doi:10.1080/13549839.2020.1789854
  21. Mu, Y., Bossink, B., and Vinig, T. (2019). Service innovation quality in healthcare: service innovativeness and organisational renewal as driving forces. Total quality management & business excellence, 30(11&12):1219-34. Doi: 10.1080/14783363.2017.1362954
  22. O’Donovan, J., Hamala, R., Namanda, A.S., Musoke, D., Ssemugabo, C., and Winters, N. (2020). ‘We are the people whose opinions don’t matter’: a photo voice study exploring challenges faced by community health workers in Uganda. Global public health, 15(3):384-401. Doi: 10.1080/17441692.2019.1663233
  23. Okpala, P. (2020). Increasing access to quality healthcare through collaborative leadership. International journal of healthcare management, 13(3): 229-35. Doi: 10.1080/20479700.2017.1401276
  24. Omona, K., and Namuli, W., (2020). Factors influencing utilisation of intra-uterine device among postpartum mothers at Gombe hospital, Butambala district, Uganda. Cogent medicine, 7(1). Doi: 10.1080/2331205X.2020.1846264
  25. Rahman, S.Y. (2020). ‘Social distancing’ during COVID-19: the metaphors and politics of pandemic response in India. Health sociology review, 29(2):131-39. Doi: 10.1080/14461242.2020.1790404
  26. Richter, J.P., and Kazley, A.S. (2020). Social media: How hospital Facebook activity may influence patient satisfaction. Health marketing quarterly, 37(1):1-9. Doi: 10.1080/07359683.2020.1713573
  27. Ronca, E., Svheel-Sailer, A., Koch, H.G., Essig, S., Brah, M., Munzel, N., Gemperli, A., and swiSCI study group (2020). Satisfaction with access and quality of healthcare services for people with spinal cord injury living in the community. The journal of spinal cord medicine, 43(1):111-21. Doi: 10.1080/10790268.2018.1486623
  28. Simmons, A.L. (2020). COVID-19 social distancing: A snippet view of the autistic social world. Disability & society, 35(6):1007-11. Doi: 10.1080/09687599.2020.1774866
  29. Suleri, J. (2020). Learners’ experience and expectations during and post COVID-19 in higher education. Research in hospitality management, 10(2):91-9. Doi: 10.1080/22243534.2020.1869463
  30. Thuy, H.T., Ha, D.T., Tuong, P.V., Thinh, C.Q., and Nga, N.T. (2020). Availability of essential medicines in primary healthcare in Vietnam. International journal of healthcare management. Doi: 10.1080/20479700.2020.1756093
  31. Varea, V., and Gonzalez-Calvo, G. (2020). Touchless classes and absent bodies: teaching physical education in times of covid-19. Sport, education and society. Doi: 10.1080/13573322.2020.1791814
  32. Walcott, R.L., Ingels, J.B., Corso, P.S., Zalwango, S., Whalen, C.C., and Sekandi, J.N. (2020). There’s no such thing as a free TB diagnosis: catastrophic TB costs in urban Uganda. Global public health, 15(6): 877-88. Doi: 10.1080/17441692.2020.1724313
  33. Wasdani, K.P., and Prasad, A. (2020). The impossibility of social distancing among the urban poor: the case of an Indian slum in the times of COVID-19. Local environment, 25(5):414-8. Doi: 10.1080/13549839.2020.1754375
  34. World health organisation. (2016). Public financing for health in Africa: from Abuja to the SDGs. Health financing toward UHC.
  35. Wright, C. (2020). Local government fighting COVID-19. The round table, 109(3):338-9. Doi: 10.1080/00358533.2020.1763017
  36. Xie, X., Siau, K., and Nah, F.F. (2020). COVID-19 pandemic-online education in the new normal and the next normal. Journal of information technology case and application research, 22(3):175-87. Doi: 10.1080/15228053.2020.1824884