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Uganda Hospital and Health Centre IV Census Survey 2014

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Uganda Hospital and Health Centre IV Census Survey 2014 THE REPUBLIC OF UGANDA MINISTRY OF HEALTH Uganda Hospital and Health Centre IV Census Survey 2014 THE REPUBLIC OF UGANDA MINISTRY OF HEALTH Uganda Hospital and Health Centre IV Census Survey 2014 2 4 6 Table of Contents FOREWORD MINISTER ............................................................................................................................ 3 ACKNOWLEDGEMENT ............................................................................................................................. 5 Table of Contents .................................................................................................................................... 7 List of tables ............................................................................................................................................ 9 List of figures ......................................................................................................................................... 11 List of Acronyms .................................................................................................................................... 17 EXECUTIVE SUMMARY .......................................................................................................................... 18 INTRODUCTION ..................................................................................................................................... 32 1.1. Background ............................................................................................................................. 32 1.2. Understanding delivery of health services in Uganda ............................................................ 33 1.3. Uganda’s Population .............................................................................................................. 35 1.4. METHODOLOGY ...................................................................................................................... 37 Findings ................................................................................................................................................. 39 1. Access to hospitals and level IV primary care facilities .......................................................... 39 1.1. The availability of hospitals and Level IV primary care facilities ........................................ 39 1.2. Hospital bed density ........................................................................................................... 43 1.3. Outpatient service utilisation rates in Hospitals/HC IVs ..................................................... 46 1.4. Inpatient admission rates in hospitals/HC IVs .................................................................... 48 1.5. Referral services .................................................................................................................. 51 1.6. Ambulance services ............................................................................................................ 53 1.7. The availability of non-specialty medical and surgical services .......................................... 56 1.8. The availability of specialty medical and surgical services ................................................. 61 1.9. The availability of advanced diagnostic and treatment services ........................................ 67 1.10. The availability of emergency services ............................................................................ 74 1.11. The availability of blood transfusion services ................................................................. 77 1.12. The availability of laboratory services ............................................................................. 80 2. Quality and safety ................................................................................................................... 83 2.1. Maternal Mortality ............................................................................................................. 84 2.2. Still births ............................................................................................................................ 86 2.3. Neonatal mortality .............................................................................................................. 88 2.4. Caesarean sections ............................................................................................................. 91 2.5. Infection prevention and control ........................................................................................ 93 2.6. Systems and practices to ensure quality of health care ..................................................... 97 7 2.7. Systems and practices for ensuring safety of staff and service users .............................. 102 2.8. Readiness for offering emergency services ...................................................................... 107 2.9. Readiness for offering advanced diagnostic and treatment services ............................... 115 2.10. Readiness to offer delivery care .................................................................................... 118 2.11. Readiness to offer services on the adult inpatient surgical ward ................................. 124 2.12. Readiness to offer services on the maternity (post-delivery) ward .............................. 132 2.13. Readiness to offer services on paediatric ward ............................................................ 140 2.14. Readiness to offer blood transfusion services .............................................................. 148 2.15. Readiness to offer laboratory services .......................................................................... 153 2.16. The availability of medicines ......................................................................................... 165 3. Health system ....................................................................................................................... 188 3.1. Hospital/HC IV governance and management ..................................................................... 189 3.2. Staffing levels at hospitals .................................................................................................... 193 3.3. Health care financing ............................................................................................................ 196 4. Efficiency .............................................................................................................................. 197 4.1 Average length of stay .......................................................................................................... 198 4.2 Bed occupancy rate .............................................................................................................. 199 Conclusion ........................................................................................................................................... 202 Annexes ............................................................................................................................................... 203 Annex 1: Hospital Census Field Team (Field Supervisors and Data Collectors) .............................. 203 Annex 2: Clusters of districts by region .......................................................................................... 204 Annex 3: Tables of results ............................................................................................................... 207 8 List of tables Table 1: The organisational structure and functions of government health services in Uganda ......... 36 Table 2: Absolute number of hospitals and level IV primary care facilities, by key stratifiers ............. 40 Table 3: Bed density, by geographical zone (n=335) ............................................................................ 45 Table 4: Number of OPD attendances in hospitals/HC IV, by key stratifiers ........................................ 47 Table 5: Number of inpatient admissions, by key stratifiers ................................................................ 50 Table 6: Number of people per facility offering non-specialty services, by geographical zone (n=334*) .............................................................................................................................................. 57 Table 7: List of the specialty services that were enquired about during the hospital census .............. 61 Table 8: Number of people per hospital offering specialty services (n=147*) ..................................... 63 Table 9: Number of people per hospital offering advanced diagnostic and treatment services, by geographical zone ................................................................................................................. 69 Table 10: List of districts that did not have any of the advanced diagnostic and treatment services that were enquired about .................................................................................................... 70 Table 11 Caesarean section rate, by key stratifiers .............................................................................. 92 Table 12: Items enquired about to assess capacity for infection prevention and control ................... 93 Table 13: List of items used to assess capacity to offer emergency services ..................................... 110 Table 14: Among the hospitals/HC IVs that reported offering emergency services, the percentage that reported having the indicated emergency support services .....................................
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