Readiness of health facilities to manage individuals infected with COVID-19, Uganda, June 2021

BMC Health Services Research

Research

Paul E. Okello¹  Irene B. Kyamwine¹  Fred Monje²  Sarah Elayeete²  Petranilla Nakamya²  Stella M. Migamba²  Alice Asio²  Hilda T. Nansikombi²  Patience Mwine²  Sherry R. Ahirirwe²  Andrew Kwiringira²  Rose Nampeera²  Immaculate Atuhaire²  Allan Komakech²  Shaban Senyange²  Edirisa J. Nsubuga²  Veronicah Masanja²  Daniel Kadobera³  Lillian Bulage³  Alex R. Ario³  Benon Kwesiga³  Julie R. Harris⁴  Sandra Nabatanzi⁴ 

[1] Uganda National Institute of Public Health, Kampala, Uganda;Uganda Public Health Fellowship Program, Kampala, Uganda;Uganda Public Health Fellowship Program, Kampala, Uganda;Uganda National Institute of Public Health, Kampala, Uganda;United States Centers for Disease Control and Prevention, Kampala, Uganda;

关键词: COVID-19;    Pandemic;    Second wave;    Health facilities;    Readiness;    Uganda;   

DOI  :  10.1186/s12913-023-09380-0

 received in 2022-08-08, accepted in 2023-04-09,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThe COVID-19 pandemic overwhelmed the capacity of health facilities globally, emphasizing the need for readiness to respond to rapid increases in cases. The first wave of COVID-19 in Uganda peaked in late 2020 and demonstrated challenges with facility readiness to manage cases. The second wave began in May 2021. In June 2021, we assessed the readiness of health facilities in Uganda to manage the second wave of COVID-19.MethodsReferral hospitals managed severe COVID-19 patients, while lower-level health facilities screened, isolated, and managed mild cases. We assessed 17 of 20 referral hospitals in Uganda and 71 of 3,107 lower-level health facilities, selected using multistage sampling. We interviewed health facility heads in person about case management, coordination and communication and reporting, and preparation for the surge of COVID-19 during first and the start of the second waves of COVID-19, inspected COVID-19 treatment units (CTUs) and other service delivery points. We used an observational checklist to evaluate capacity in infection prevention, medicines, personal protective equipment (PPE), and CTU surge capacity. We used the “ReadyScore” criteria to classify readiness levels as > 80% (‘ready’), 40–80% (‘work to do’), and < 40% (‘not ready’) and tailored the assessments to the health facility level. Scores for the lower-level health facilities were weighted to approximate representativeness for their health facility type in Uganda.ResultsThe median (interquartile range (IQR)) readiness scores were: 39% (IQR: 30, 51%) for all health facilities, 63% (IQR: 56, 75%) for referral hospitals, and 32% (IQR: 24, 37%) for lower-level facilities. Of 17 referral facilities, two (12%) were ‘ready’ and 15 (88%) were in the “work to do” category. Fourteen (82%) had an inadequate supply of medicines, 12 (71%) lacked adequate supply of oxygen, and 11 (65%) lacked space to expand their CTU. Fifty-five (77%) lower-level health facilities were “not ready,” and 16 (23%) were in the “work to do” category. Seventy (99%) lower-level health facilities lacked medicines, 65 (92%) lacked PPE, and 53 (73%) lacked an emergency plan for COVID-19.ConclusionFew health facilities were ready to manage the second wave of COVID-19 in Uganda during June 2021. Significant gaps existed for essential medicines, PPE, oxygen, and space to expand CTUs. The Uganda Ministry of Health utilized our findings to set up additional COVID-19 wards in hospitals and deliver medicines and PPE to referral hospitals. Adequate readiness for future waves of COVID-19 requires additional support and action in Uganda.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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Fig. 1