Mpigi District Health Care Service Status Report Final Report-2016
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MPIGI DISTRICT HEALTH CARE SERVICE STATUS REPORT August 2016 TABLE OF CONTENTS LIST OF ACRONYMS ................................................................................................................................................. ii Chapter One: BACKGROUND .................................................................................................................................. 1 1.1 About Us........................................................................................................................................................ 1 1.2 Background ................................................................................................................................................... 1 1.3 Specific Objectives of the Monitoring Exercise ............................................................................................. 3 1.2 Methodology ................................................................................................................................................. 3 Chapter Two: FINDINGS .......................................................................................................................................... 4 2.1 Human Resources for Health ........................................................................................................................ 4 2.2 Leadership and Governance ......................................................................................................................... 5 2.3 Medical Services............................................................................................................................................ 6 2.4 Medical Supplies ........................................................................................................................................... 9 2.5 Infrastructure and Equipment Management .............................................................................................. 12 2.6 Vermin Control ............................................................................................................................................ 16 2.7 Finances and Administration ...................................................................................................................... 16 Chapter Three: RECOMMENDATIONS .................................................................................................................. 20 i LIST OF ACRONYMS ANC – Antenatal Care CAO – Chief Administrative Officer DHO – District Health Officer FY – Fiscal Year GAVI – Global Alliance for Vaccines Initiative HC – Health Centre HMU – Health Monitoring Unit HSD – Health Sub District HUMC – Health Unit Management Committee MRDT – Malaria Rapid Diagnostic Test mTrac – Mobile Tracking NMS – National Medical Stores OPD – Outpatients Department PHC – Primary Health Care PNFP – Private Not For Profit SMS – Short Messaging Service UNICEF – United Nations Children’s Fund VHT – Village Health Team ii Chapter One: BACKGROUND 1.1 About Us The Health Monitoring Unit (HMU) was established seven years ago with a mandate to monitor health services in the country. HMU’s goal is to monitor the efficiency and accountability of Uganda’s healthcare system so as to raise the bar in healthcare. Our vision is to see a healthy Ugandan population supported by an effective and responsive healthcare system. In order to achieve this, we continue to focus on striving for better health, better systems, and better value for money. Our core values are Quality, Undaunted, Integrity, Excellence and Teamwork. 1.2 Background Mpigi district is a peri-urban district, with a population of 251,512 as of the 2014 population census. The district is divided into two health sub districts (HSDs), namely: Mawokota North and Mawokota South. It has only one hospital (Nkozi General Hospital – Mawokota South HSD headquarters) which is a Private Not For Profit (PNFP) facility and one government HC IV (Mpigi HC IV – Mawokota North HSD headquarters), which ought to be upgraded to a general hospital status. HMU over time received numerous complaints about the status of health care service delivery through various platforms including the mTrac dashboard as shown in table 1 below. Table 1: Some of the complaints / reports received on the anonymous mTrac dashboard Facility Date Reports Comments Butoolo 13/09/ We don't get medicine at butoro health center HC III 2016 kammengo mpigi the situation is alarming please help DHT, for your attention Butoolo 17/07/ Musawo sekiipi Ku dwaliro a butoolo atujako Sente fe HC III 2015 abalwadde ba pulesa ate tetulina sente Aba VHT EBUWAMA sub County twagema abaana Buwama 01/10/ polio nqa 1 ne 2 Dec.216 temwatuwa kantu konna "We VHTs were given any facilitation HC III 2016 yadde entambula lwaki kiri bwekityo when we immunized for polio 1 and 2" Buwama 23/04/ Ssebo abebuwama mutuwa eddagala tonno the drugs supplied to the health center HC III 2016 mutuyambe. are not enough BANANGE TUKUBA OMULANGA KUDWALILO Please come to our rescue as we lack Kibumbir 23/05/ LYEKIBUMBILO TEMULIMUUDAGALA ELYAFFE drugs at Kibumbiro Hc. DHT, for your o HC II 2015 ABALWADDE. immediate action and follow up ENO EMPIGI KIRINGENTE,EKAGEZI,TUBEBAZZA Kiringent OKUWA OMUSAWO AYITIBWA.MUSAWO e Epi SSEBATA.PETER, KUDWALILO KAGEZI Centre 14/08/ EPICENTER. AKOLA.NE KU.WEEKEND, HC II 2016 EKITALIWWO. Good Service Report Kituntu 03/09/ POOR SERVICE KITUNTU HEALTH CNTRE !!! HC III 2015 MPIGI 1 Facility Date Reports Comments Mpigi 22/05/ DHT, for your immediate action and HC IV 2015 No Drugs From Mpigi Health Centre follow up Nze nemulugunya kuba sawo Muduuma heath center Muduum 10/08/ lll Mpigi District. Batandika okuttuka kuddelwaliro a HC III 2016 sawa (5) ate muddwaliro temuli dagala Muddwaliro Emudduma - Mpigi, Abasawo Batusaba In Muduma HC III we are charged for Sente Okutukebeera Omusayi, N'okutukula Amanyo blood tests and dental services. please Muduum 11/02/ Mutuyambe Tufaa, Bwoba Tolina Sente Tofuuna help us, if you dont have money you a HC III 2016 Bujjanjabi. dont get services Muduum 18/12/ edwalilolyemuduumalyaganvumentnayebatusenteant a HC III 2015 enyinjibatandikirakumitwaloentanomubagambeko. Muduum 13/08/ no drugs in muduuma health centre 3,mpigi district. DHT, for your immediate action and a HC III 2015 why? follow up HEALTH WORKERS AT MUDUUMA HEALTH Muduum 19/05/ CENTER ARE SO CARING THANK YOU BUT THEY a HC III 2015 COME LATE Nabyew anga HC 30/01/ "There are no midwives in II 2016 Edwalilolyenabyewangatemulimubazalisa Nabyewanga health centre" NABYEWANGA HEALTH CENTRE II MUMPIGI There are no drugs in Nabyewanga Hc Nabyew TEMUBEERA DDAGALA KATI NAKU 3O. II in Mpigi district for 30 days now. anga HC 08/09/ ABASAWO BTUUKA SAAWA TAANO KU Health workers reach the facility at 11: II 2015 DDWALIRO MUTUYAMBE TULIBUBI NNYO. am. please help us. banange tusaba mutuyambe bekiikwatako empiji Nabyew mukore orukiiko nga rugata abalwadde nabasowo anga HC 25/06/ muwuriire obuziibu byeturina kubanga tuffa.omwavu II 2015 talwarenga? I was at nabyewanga the other day requesting for health worker to come akora mumateneti nansaba sente nemwegayirira to my rescue and she told me poor Nabyew anyambe nagana nambuza nt'omwavu people donot deliver children or go into anga HC 11/05/ azara?tubegayiride mutukyusizemu on'mukyara ye labor. She refused to help me unless I II 2015 ayagara sente atuyisa bubi. paid her money. There are no drugs at nindye hc3. Nindye 16/08/ DHT, for your immediate action and HC II 2015 NNINDYE H/C III temuli ddagala okumala sabiiti 2. follow up "Please help us. We have very few Nkozi health workers in Nkozi" HOSPIT 28/04/ MUTUYAAMBE KO ENKOZI TULINA ABASAWO AL 2016 BATONO. DHT, for your attention. Nkozi HOSPIT 18/12/ AL 2015 Nkozi Hospital lacks opticians Nkozi There are no health workers on duty at HOSPIT 23/04/ Nkozi Hospital. DHT, for your AL 2015 Nkozi teli basauo kuba feabaluo tuo koye otuola immediate action and follow up Nsamu/ Kyali HC 28/06/ Edwaliro lye mu kwaba mpigi district kyali batunda III 2016 edagala lya goverment There is no services here at ssekiwunga health center Sekiwun 28/06/ 3, in mpigi district, please help us in those warkers ga HC II 2016 thanks DHT, for your attention. Sekiwun 06/10/ MORE PATIENTS NO NURSES IN SEKIWUNGA ga HC III 2016 H/C (111), MPIGI DISTRICT, 2 Facility Date Reports Comments Ssekiwu SEKIWUNGA HEALTH CENTRE 3 MPIGI THEY DO nga HC 28/07/ HAVE ANY MEDICENI EVEN PANADOL OR III 2015 ASPRIN Ssekiwu nga HC 27/07/ i-)SEKIWUNGA TEBALINA DAGALA WANDE NE III 2015 KAPANADO NEKA ASPRIN There are no drugs not even Panadol. 1.3 Specific Objectives of the Monitoring Exercise To assess the level of effectiveness within the health service delivery systems of the district through direct monitoring of health facilities. To identify and rectify any forms of healthcare malpractice, poor administration and mismanagement of healthcare resources. To provide feedback to all stake holders involved in health service delivery as well as the public, so as to jointly work-out practical solutions. 1.2 Methodology The HMU team conducted site visits of Public and PNFP health facilities in the district. The evaluation exercise took on the form of on-spot un-announced visits to selected health facilities, where monitoring was conducted with the guidance of an approved data collection tool and observation checklists. Areas of interest were: infrastructure and equipment inventory, medicines management and audit, financial expenditure audit, staffing, administration and effectiveness of