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Surgical Care Capacity in Uganda: Government Versus Private Sector Investment

Surgical Care Capacity in Uganda: Government Versus Private Sector Investment

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dc.contributor.author Nseyo, Unwanaobong
dc.contributor.author Cherian, Meena N.
dc.contributor.author Haglund, Michael M.
dc.contributor.author Hudson, Jessica
dc.contributor.author Sentumbwe-Mugisa, Olive
dc.contributor.author Okello, Margaret
dc.contributor.author Toliva, Opar Bernard
dc.contributor.author Johnson, Walter D.
dc.date.accessioned 2021-01-01T21:58:16Z
dc.date.available 2021-01-01T21:58:16Z
dc.date.issued 2017
dc.identifier.issn 0020-8868
dc.identifier.uri http://combine.alvar.ug/handle/1/48238
dc.description.abstract Background: Uganda is a low-income country with blended, tiered government health care facilities and private/non-governmental (NGO)/mission hospitals. The population is 84% rural; 100% of referral hospitals and majority of specialist physicians are urban. Summary of background data: This project compared various levels of government hospitals with private/NGO hospitals to determine adequacy to deliver emergency and essential surgical care (EESC) and anesthesia. Methods: Using the WHO Situational Analysis Tool, a representative selection of 38 hospitals (25% of Ugandan hospitals) was assessed for capacity to deliver surgical, anesthetic and obstetric care in 4 domains: infrastructure, human resources, surgeries performed or referred, and equipment. Results: In all facilities, laboratory availability was 86%; anesthesia machines, 66%; generators, 55%; and continuous running water, 42%; oxygen, 32%; and electricity, 26%. Resuscitator bags and mask/tubing were present less than 50% of health facilities. Only 84% of all health facilities had a stethoscope; sterilizers only at 50%. This situation was much more dismal in district hospitals. Surgeons were found at 71% of public hospitals and 63% of NGO/mission hospitals; 60% surgeons, and over 50% of anesthesiologists were only in teaching hospitals; obstetricians almost exclusively in higher-level hospitals. Conclusions: The infrastructure for surgical services and anesthesia were noticeably absent at district hospital level and below, yet were readily available at the tertiary care center level. Overall national and regional referral hospitals were better equipped than NGO facilities, suggesting the government is capable of fully equipping hospitals to provide surgical care. These surveys highlight potential for improvement in surgical care at all levels.
dc.language English
dc.publisher INT COLLEGE OF SURGEONS
dc.relation.ispartof International Surgery
dc.subject Surgery
dc.subject Anesthesia
dc.subject Obstetrics
dc.subject Uganda
dc.subject Oxygen
dc.subject District Hospital
dc.title Surgical Care Capacity in Uganda: Government Versus Private Sector Investment
dc.type Article
dc.identifier.isi 000443007400018
dc.identifier.doi 10.9738/INTSURG-D-16-00153.1
dc.publisher.city CHICAGO
dc.publisher.address 1516 N LAKE SHORE DR, CHICAGO, IL 60610 USA
dc.identifier.volume 102
dc.identifier.issue 7-8
dc.identifier.spage 387
dc.identifier.epage 393
dc.subject.wc Surgery
dc.subject.sc Surgery
dc.description.oa Other Gold
dc.description.pages 7
dc.subject.kwp Emergency
dc.description.affiliation Univ Calif San Diego, Dept Urol, San Diego, CA 92103 USA
dc.description.affiliation WHO, Emergency & Essential Surg Care Programme, 20 Ave Appia, CH-1211 Geneva 27, Switzerland
dc.description.affiliation Duke Univ, Med Ctr, Div Neurosurg, Durham, NC 27710 USA
dc.description.affiliation WHO Country Off, Kampala, Uganda
dc.description.affiliation Mulago Hosp, Dept Anesthesia, Kampala, Uganda
dc.description.affiliation Minist Hlth, Kampala, Uganda
dc.description.email johnsonw@who.int
dc.description.corr Johnson, WD (corresponding author), WHO, Emergency & Essential Surg Care Programme, 20 Ave Appia, CH-1211 Geneva 27, Switzerland.


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