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Kiryandongo District REPORT June 2013 Medicines and Health Service Delivery Monitoring Unit (MHSDMU) Plot 21 Naguru H

Kiryandongo District REPORT June 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). WHAT IS MHSDMU?.

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Kiryandongo District REPORT June 2013 Medicines and Health Service Delivery Monitoring Unit (MHSDMU) Plot 21 Naguru H

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  1. Kiryandongo District REPORT June 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)

  2. WHAT IS MHSDMU? • MHSDMU is a department set up by a presidential instrument to monitor health service delivery in Uganda • The department is apolitical • Does not override the functions of MoH, which has the constitution mandate to oversee health activities in the country

  3. MHSDMU OBJECTIVES • The main objective is to raise the bar in health service delivery • Other specific objectives include to assess health service delivery in health facilities • To identify and rectify any forms of healthcare malpractice, poor administration and mismanagement. • To find out possible immediate and long term solutions together with partners (stakeholders)

  4. INFORMATION HARNESSING • MTraC – free sms to 8200 • Public complaints • MOH • Toll free line - 0800100447 • Partners e.g ISO, Police • Politicians e.g LCs • Whistle blowers e.g health workers

  5. The Kiryandongo District Visit • Motivation: Prompted by the several mTrac reports of negligence, absenteeism, extortion especially at the district hospital • Timing: Performed between 4th – 14th Jun 2013

  6. The Kiryandongo District Visit - Approach • On-spot unannounced visits to all public health facilities in the district

  7. The Kiryandongo District Visit – What did we look at? • Human resource • Infrastructure and equipment • Finance and administration • Medical supplies • Medical services delivery • Laboratory, infection and vector control

  8. The Kiryandongo District Visit – Facilities Visited • Kiryandongo district Hospital • Kigumba HCIII • Panyadol HCIII • Mutunda HCIII • Masindi port HCIII • Diima HCIII, • Nyakadoti HCII • Yabweng HCII • Kiroko HCII • Karuma HCII • Kaduku HCII • Diika HCII • Kitwara HCII • Teecwa HCII • Kicwabugingo HCII • Apodorwa HCII • Mpumwe HCII

  9. Our Findings

  10. Human Resources • All facilities found to have less than the recommended number of staff. • Hospital most adversely affected

  11. Finance and administration • Lower health centres better managed compared to facilities of a higher level. No financial audit queries found at Kaduku HCII Particularly, the district hospital found to have queries amounting to UgX16,136,258. Symptoms of mismanagement at the district hospital

  12. Infrastructure and equipment • Lower level health facilities were observed to have better maintained infrastructure when compared to higher level faclities Unkept - Kigumba HCIII Dilapidated - District Hospital Well maintained - Diima HCIII Rather Stalled Shoddy work – Nyakadoti HCII

  13. Medical supplies • Lower level facilities assessed to have better accountability for drugs and other supplies. • Expired drugs were evident in almost all visited facilities Well-shelved drugs at Kitwara HCIII Good records keeping at Diima HCIII • Particularly, wide gaps found within the drug audits at the district hospital, no dispensing logs in certain wards Poor house-keeping at district hospital main store

  14. Medical Service Delivery • Patients appeared to have more confidence with the services of lower facilities, especially HCII’s & HCIII’s • In the district hospital however, doctors were not honoring the duty roster, which led to loss of lives, especially on the male, female, maternity and peadiatric wards. • Herstory – found with convulsing child at Kiroko HCII at 11.40am, no health worker, incharge went with the facility’s keys to Gulu. She was carried to the district hospital for admission. • Health workers atKitwaara, Masindi Port and Nyakadoti smartly clad in uniforms. Good performance starts with being smart at work

  15. Vector and Infection Control • Generally infection control measures were in place Vermine

  16. Acknowledgement • Health workers that are committed • Health partners in the district: IDI,SURE, Malaria consortium • RDC & DISO Hoima • Police (DPC, CLO, OC CID) • Tullow • Hoima LG • NMS

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