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KALANGALA FIELD REPORT April 2013 Medicines and Health Service Delivery Monitoring Unit (MHSDMU)

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KALANGALA FIELD REPORT April 2013 Medicines and Health Service Delivery Monitoring Unit (MHSDMU) Plot 21 Naguru Hill Drive P.O Box 25497 Kampala Tel: 0414-288442, 0414-288445, 0800100447 (Toll free). Introduction.

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KALANGALA FIELD REPORT

April 2013

Medicines and Health Service Delivery Monitoring Unit (MHSDMU)

Plot 21 Naguru Hill Drive

P.O Box 25497

Kampala

Tel: 0414-288442, 0414-288445, 0800100447 (Toll free)

introduction
Introduction
  • The monitoring exercise in Kalangala district was carried out between 8th – 12th of April 2013.
  • The visit was prompted by a number of complaints generated through M-trac anonymous SMS and calls through the MHSDMU toll free line.
  • The facilities visited were:
  • Kalangala HCIV
  • MugoyeHCIII
  • SiaapHCII
introduction continuation
Introduction continuation
  • Lulamba HCIII
  • Jaana HCII
  • Bubeke HCIII
  • Bufumira HCIII
  • Bukasa HCIV
  • Mazinga HCIII
  • Bwendero HCIII
  • Mulabana HCII
appreciation
Appreciation
  • MHSDMU appreciatesall the health staff, for coming to work in this hard to reach area.
  • Special thanks go to the in-charges and staff of Mazinga HCIII and Jaana HCIII for being exemplary.
  • We also thank the entire leadership of all the health centers for ensuring that drugs do not expire in their stores.
major findings
Major Findings
  • Human resource
  • There is total lack of orientation of workers by DHO.
  • Supervision is lacking. DHO does not do monitoring.
  • Despite Kalangala being a hard to reach place, the staff are not getting hard to reach allowance.
  • Many recruited staffs have not reported.
  • The daily staff reporting registers lack in most health centers, and where they are, they are not adhered to.
  • Mogoye HCIII staff were found with forged staff attendance register.
human resource cont
Human resource cont….
  • There is general late coming and absenteeism; Staffs come late and leave early. Especially the I/C of Mugoye- Bogere, I/C of Kalangala HCIV, the staff of Bwendero HCIII etc.
  • The newly recruited staff are not yet on payroll, which makes their survival difficult.
  • Lack of staff uniforms was noted in all the health centers visited.
  • Shortage of staff accommodation in all health centers.
  • Misconduct: the team witnessed a health worker who was seeing patients while watching a movie and listening to music on his laptop.
finance and administration
Finance and Administration
  • The team noted missing financial accountability / poor financial accountability in the lower health centers visited.
  • Accountability for HCIVs was fair, though they receive little PHC of 1,800,000/= per quarter, which is not enough to run a HCIV.
infrastructure and equipment
Infrastructure and Equipment
  • Existence of dilapidated structures in some of the health centers. E.g staff quarters of BwenderoHCIII and Kalangala HCIV. At BwenderoHCIII, a Lab Assistant was hit by debris in her house.
infrastructure and equipment cont
Infrastructure and Equipment cont…..
  • The team discovered that the bicycle and motorcycle given to Mulabana HCII were missing.
  • The monitoring team found very unkempt and dirty facilities in the district e.gMugoye HCIII and Bwendero HCIII.
  • No inventory management in the whole district, and this risks government property.
  • All the equipment in the district is not engraved, and the district might end up losing its property.
infrastructure and equipment cont1
Infrastructure and Equipment cont…..
  • All Health centers in the district are not fenced and lack land titles, andsome have been encroached on.
infrastructure and equipment cont2
Infrastructure and Equipment cont…..
  • Most health centers are infested by bats, Vermins etc.
medical services
Medical services
  • Bukasa HCIV is under performing. The services offered at the health center are similar to those of a health center two, despite the infrastructure and equipment in place.
  • Few or no deliveries done in some of the HCIIIs. E.g in Bwendero HCIII there were no deliveries in February, in Lulamba HCIII, the mid-wife refused to attend to mothers, and no delivers are done.
  • Lack of placenta pits was noted in most health centers. E.gBukasa HCIV, Mazinga, Bafumira, Lulamba.
  • There is generally poor record keeping in all the facilities in the district.
medical supplies
Medical supplies
  • A lot of anti-malarial is yet to expire in health centers. E.gBwendero HCIII, Mulabana HCII, Bafumira HCIII, Bukasa HCIV.
  • There are excessive medicines in Health facilities, especially anti-malarials, paracetamol, IV fluids and eardrops of gentamycin and Chloramphenicol.
  • Medicines management is very poor in all health centers. i.e.
  • There is still poor compliance to HMIS tools most especially those used in medicines management.
  • Lack of records, and therefore drug d audit could not be done to establish the gaps.
medical supplies cont
Medical supplies cont…
  • Expired drugs found at Kalangala HCIV
theatre
Theatre
  • Though doctors were recruited at Kalangala HCIV, the theatre still does only minor surgeries.
  • At Bukasa HCIV, the theatre was abandoned, all the doors and windows were eaten up by termites, and the structure now provides shelter to chicken and goats.
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