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Kitovu Health Care Complex P.O. Box 524 Masaka

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Kitovu Health Care Complex P.O. Box 524 Masaka KITOVU HEALTH CARE COMPLEX P.O. BOX 524 MASAKA In Christ We Serve ANNUAL ANALYTICAL REPORT 2008/2009 COMPILED BY THE MEDICAL SUPERINTENDENT KITOVU HOSPITAL Kitovu Hospital Annual Report 2008/2009 Endorsement of Report This annual analytical report for Kitovu Hospital covering the period 2008/2009 has been prepared by the management of Kitovu Hospital. I endorse that it represents management’s views on the position of the hospital in the period under report. Sr. Scholastica Nakakawa Chief Executive Officer Kitovu Hospital Date 30th October 2009 This is to acknowledge that I have received this annual analytical report for Kitovu Hospital covering the period 2008/2009 I have read it and endorse its authenticity and representative of the position of the hospital in the year under report Rev. Fr. Denis Ddamulira Chairperson of the Board of Governors Date 30th October 2009 Kitovu Hospital Annual Report 2008/2009 2 Kitovu Hospital Annual Report 2008/2009 TABLE OF CONTENTS: Abbreviations: ……………………………………………………….………... 4 - 5 Executive Summary: ……..…………………………………………………..…. 6 - 9 Introduction: ……………………………………………………………….……. 10 The Hospital and its Environment: ………………………………………...…… 11-13 The Community and Health Status: …………………………………………….. 13-14 Health Policy and District Health services: ……………………………………………………....... 15-16 Governance and Management:…………………………………………….……... 17-20 Human Resource: ………………………………………………………..……… 21-26 Finance: ……………………………………………………………...……. 27 Activities: Curative: OPD: ……………………………………………………………..….…. 28-31 Wards:……………………………………………………..………. 32-41 Special Curative Services: Tuberculosis: …………………………………………………….….…. 42 Obstetric Fistula Unit: ……………………………………….…….…... 43 PMTCT: ………………………………………………..………….…… 44-45 HIV Counselling and Testing/VCT: ……………………..….………. 46-50 Supportive: Laboratory and Blood Bank: ……………………………...…………..... 50-53 Pharmacy: ……………………………………………………....……… 53-56 X – ray: …………………………………………………..………..…… 56-57 Ultrasound: ………………………………………………………....….. 57-58 Domestic Services: ……………………………………………….……. 58-63 Ambulance Services:……………………………………..…………..… 64 Pastoral Care and Social Care…………………………………………... 65-68 Preventive and Promotive Services: Community Based Health Care & Nutrition Unit:…………………..…. 69-72 Kitovu Community Health Insurance Scheme: …………………….….. 72-77 Health Training Institution: Laboratory Training School: ………………………………………………...….. 77-79 Conclusion: ………………………………………………………………..…… 80 -83 Future Plans: ……………………………………………………………..…... 83 -84 Acknowledgments: …………………………..…………….……….…… 84-86 Annexes: HMIS: …………………………………………………………… ………….…. i Board of Governors: …………………………………………………………..... ii (a) Members of the Finance and Planning Committee ………………….………..… (b) Member of Management Team: ……………………………………………....… (c) Kitovu Hospital Annual Report 2008/2009 3 Kitovu Hospital Annual Report 2008/2009 Hospital Staff form by end of Financial Year: ..…………………………..…..… iii Comprehensive Financial Report: ……………….……………………….….…. iv ABBREVIATIONS: AIDS - Acquired Immune Deficiency Syndrome ANC - Antenatal Care APSO - Agency for personnel services overseas. (Since 04/05 is BS - Blood Slide C VD - Cerebrol - Vascular Accident C.B.H.C - Community Based Health Care CCF - Congestive Heart Failure CHW - Community Health Workers CPE - Clinical Pastoral Care CS - Caesarian Section DDHS - District Director of Health Services DHO - District Health Offices DHB - Diocesan Health Board DM - Daughters of Mary DM - Diebetes Mellitus DOT - Direct Observation Treatment E.D.P - Essential Drug Program G.E - Gastroenteritis GID - Gastrointestinal Disease GYN - Gynaecology HAART - Highly Active Antiretrovial Treatment Hb - Hemoglobin HCT - HIV counselling and Testing HIV - Human Immune Virus HSD - Health Sub District Kitovu Hospital Annual Report 2008/2009 4 Kitovu Hospital Annual Report 2008/2009 HSSP - Health Sector Strategic Plan HTN - Hypertension IMR - Infant Mortality Rate IV - Intravenous KCHIS - Kitovu Community Health Insurance Scheme LOS - Length of stay MMM - Medical Missionaries of Mary MMR - Maternal Mortality Rate MRC - Medical Research Council NGO - Non Government Organisations NMHCP - National Minimum Health Care Package NSSF - National Social Security Fund O.T - Operating Theatre OPD - Out patient Department PMTCT - Prevention of Mother to Child Transmission PNFP - Private Not for Profit PTB - Pulmonary Tuberculosis RTA - Road Traffic Accident RTI - Respiratory Track Infection STD - Sexually Transmitted Disease T.T - Tetenus Toxoid TASO - The AIDS Supportive Organisation TB - Tuberculosis Bacillai U.N.F.P.A - United Nations Family Population Association UCBHFA - Uganda Community Based Health Financing Association UCMB - Uganda Catholic Medical Bureau UGX - Uganda Shillings UK - United Kingdom USA - United States of America Kitovu Hospital Annual Report 2008/2009 5 Kitovu Hospital Annual Report 2008/2009 UTI - Urinary Tract Infection VVF - Vesico Vaginal Fistula 1. EXECUTIVE SUMMARY: Kitovu Hospital, established by the Diocese of Masaka, 54 years ago in Masaka District, Uganda, is a two hundred bed (200) Private Not For Profit (PNFP) hospital, operating under the umbrella organization of the Uganda Catholic Medical Bureau (UCMB). Achievements that have been made in the year according to last year’s plan: Achievements: 1. Revision of patients’ fees for both Medical and Surgical wards, Gyne cases and OPD was done. Majority of patients were able to pay. 2. OPD utilization has increased by 14%. (5% higher than our expected number of patients. Expected visits in a year is 30,000) There was some slight improvement in customer care relationship and reducing on waiting time. 3. Review of staff establishment as well as making sure each department has adequate staff was done. 4. New Ultra Sound machine is on the way from abroad. 5. Built of new Ash/placenta pit. 6. A Grinder for cutting and sharpening metals was brought though it got broken. 7. Preparation for starting an ARV’s and HIV clinic at the hospital is underway. Ten staff have been trained in provision of comprehensive HIV/AIDS care. 8. The compound was tendered. 9. New colorimeter and water bath have been acquired for the lab. 10. Plans to start intensive neonatal unit has been completed. Funds have been secured. 11. Funds to buy one hospital vehicle has been secured, though we are still looking for more, as 2 other hospital cars are in poor condition, plus all the cars of CBHC Programme are very old. 12. The Blood Bank was relocated to a specious old classroom block which was renovated. 13. Refurbishment of laboratory staff hostels was done. Failures: 1. No development plan for training staff for a year was made. 2. Solicit for funds for immunization for our staff against Hepatitis B, C and HIV prophlaxis; after needle stick from HIV infected patients was not accomplished though discussions were done about it. Kitovu Hospital Annual Report 2008/2009 6 Kitovu Hospital Annual Report 2008/2009 3. Monitoring sepsis or maternity did not take root as we had to shift mothers about 2 times during renovation this year. 4. Failed to increase number of isolation rooms at medical ward and to construct private rooms due to lack of funds. 5. Failure to carry out major repair of the hospital fence so as to contain security problems. 6. Failure to build and renovate staff houses. 7. Failure to obtain some equipment of laboratory e.g. haematology machine. 8. Failure to have full time fistula Repair services. 9. Failure to separate causality from Out-patient Department. 10. Plan to revise terms and conditions between Kitovu Hospital and Nakasero National Blood bank was not done. 11. The Budget was not well controlled N.B Failure to achieve most of our plans was due to inadequate finance. Other achievements: 1. We started camping sessions for Blood Bank which have boosted our blood supply. 2. Two more of our qualified midwives were properly trained for PMCT programme 3. New water reserve tank was constructed with the capacity of 55,000 litres 4. Installation of new stand alone photovoltaic solar system on Children’s Ward. 5. Refurbishment of the chemotherapy unit in Children’s Ward 6. Repair to the administration rain water collection tank. 7. New supply tanks: New polyfibre supply tanks and their towers were installed at the Laboratory Tutors House and Walungi quarters to increase on the supply of water to these houses. 8. Repairs to the existing two reserve tanks Challenges: 1. High turnover of experienced nurses and Midwives due to low salary scales compared to the government’s scale. 2. Kitovu hospital works as referral hospital but not facilitated as such by the Government via PHC grant. 3. Working as a referral unit, raises the unit cost of managing patients yet PHC grant is stagnant as well as increasing poverty level in the community. Kitovu Hospital Annual Report 2008/2009 7 Kitovu Hospital Annual Report 2008/2009 4. Non-compliant with medicines many patients with tuberculosis disease and HIV refuse to go to other Health facilities which provide continuation phase for PTB and ART’s. 5. Inadequate Medical staff residences. 6. No causality department yet the biggest emergencies are ART’s 7. Inadequate isolation rooms and lack of private rooms on Medical Ward. 8. Need of renovation and expand of OPD, Pharmacy store, central store to meet the increased demand of services. 9. The hospital vehicles are worn-out and need replacement. 10. Hospital Laboratory needs Automation machines to give more reliable results. 11. The hospital’s fence needs replacement to contain security problems. 12. Lack of Autoclave
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