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Supervision and Local Government Health Service Delivery in Uganda: A Case of Bushenyi-Ishaka Municipality, Bushenyi District
(Kampala International University; Faculty of Business and Management, 2023-03) Moureen Ainembabazi
Regular supervision is an apparent intervention that fortifies the health system, motivates health workers to offer quality health services and improve their performance. The present study aimed at determining the level of supervision, quality of health service delivery and the relationship between level of supervision and quality of health service delivery in Bushenyi-Ishaka municipality, Bushenyi district. A cross sectional research design was used in this study. Self- administered organized survey questions and oral personal to get both quantitative and qualitative data from the interviews, district administrators, health care professionals and the selected patients. Part of the primary data was retrieved from municipality registry after consultation. SPSS- version 20 was used for analysis to obtain descriptive statistics. Linear regression analysis was also conducted from which a regression model was fitted for the data as; predicted quality of health service delivery = 1.436+0.595 x (level of supervision). Statistical significance was considered at p ≤ 0.05. The study showed a positive correlation between the level of supervision and the quality of health service delivery in local government (r = 0.633). A significant improvement in the quality of health service delivery was registered when the level of supervision was increased (B = 0.595, t= 7.453, p ≤ 0.0001, 95% CI; 0.436 - 0.754). However, the quality of health service delivery in the studied area was generally poor and this was attributed to poor job satisfaction by health workers caused by inadequate supervision at some health facilities, inappropriate salaries, allowances and absence of promotions and gratuity mechanisms. This also led to increased absenteeism from duty stations and alarming complaints in the media about poor healthcare services. Furthermore, the failure of supervisors to execute their responsibilities at some health facilities worsened the health service delivery in Bushenyi district local government. The empathetic of supervisory concept and its implementation is still shrouded in Bushenyi district. Therefore, the ministry of health needs to strengthen the level of supervision of health services and prioritize on improving health workers’ job satisfaction. There is also a need to develop tracking system mechanisms of supervisors and health workers to avoid continued absenteeism from work duties.
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Loan Portfolio Management and Financial Performance of SACCOs in Rubirizi District.
(Kampala International University; Faculty of Business and Management, 2023-01) Jackline Abenaitwe
This study was about loan portfolio management and financial performance of SACCOs in Rubirizi District and it was guided by three objectives namely; to establish the relationship between loan portfolio planning and financial performance of SACCOs in Rubirizi District, to assess the relationship between client screening and financial performance of SACCOs in Rubirizi District and to examine the relationship between loan portfolio monitoring and financial performance of SACCOs in Rubirizi District. A sample of 110 respondents was obtained using the Census Method, the study used cross sectional research and correlational approaches. Self Administered Questionnaires and an interview guide were used to obtain the data. Frequency distributions, percentages, means, correlation, and regression were used to examine quantitative data and thematic analysis for qualitative data. Descriptive findings revealed that;- client screening and loan portfolio monitoring were poor, whereas loan portfolio planning scored highly. Inferential analysis results showed;- loan portfolio planning(r = 0.82**, p = 0.000 0.05) had a strong positive significant relationship with financial performance; client screening (r = 0.76**, p = 0.000 0.05) had a moderate significant relationship with financial performance; and loan portfolio monitoring (r = 0.481, p = 0.001 0.05) had a weak positive significant relationship with financial performance. As a result, it was determined that loan portfolio planning is critical for financial performance, client screening is beneficial for financial performance, and loan portfolio monitoring has a minor impact on financial performance. Based on the findings, the study suggested and recommended to the Ministry of Trade, Industries, and Cooperatives and stakeholders in SACCO management to support loan portfolio planning, client screening before extending loans to them, and Loan Portfolio monitoring as the most efficient method of detecting any breaches by SACCO clients.
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Factors Associated with Uptake of Cervical Cancer Screening Among Reproductive Aged Women attending the Gynecology Outpatient Clinic at Kampala International University Teaching Hospital
(Kampala International University; Faculty of Cinical Medicine and Dentistry, 2021-10) John Chidanga
Background. Cervical cancer remains one of leading causes of maternal morbidity and mortality. It contributes to about 7.9% of all women related cancers and is the ranked 4th among all women cancers. In the fight against cervical cancer, its prodromal and asymptomatic stage has been found to be detectable and curable. Several screening modalities like Visual Inspection with acetic acid and Lugol’s Iodine, Human Papilloma Virus DNA, Pap smear have largely been instrumental to the reduction of cervical cancer prevalence. However, the uptake to these lifesaving methods remains inexplicably low and several barriers exist towards this. These hindering factors include lack of knowledge about causes of cervical cancer, lack of knowledge on when to screen and when to start screening, personal factors like fear of pain, fear of a positive diagnosis and fear of embarrassment. The result is 80% of women who present to Uganda Cancer Institute, do so in late stage of disease and it poses a detrimental challenge to the patients, their families and the health infrastructure. Objective. To determine the factors associated with uptake of cervical cancer screening in women of reproductive age attending Gynecological OPD clinic at Kampala International University Teaching Hospital. Methodology. This was a hospital-based descriptive and analytical cross-sectional study conducted at the antenatal clinic and maternity ward of KIU-TH between August and October 2021. A sample of 309 women were recruited, open-ended questionnaires were administered and pap-smear tests were carried out for those who took up screening. Slides were analysed and results of patterns of cytological findings were documented. The datat was then analysed using logistic regression. Results. The uptake to cervical cancer screening was found to be 18.8% (95% CI, 14.8%-23.5%). In multivariable analysis, being from a rural residence, HIV positive and have 2 or more sexual partners was found to be statistically significant. Further analysis on pap smear results revealed 37.93% being normal pap smears not having any intra epithelial lesion or malignancy, 29.31% had inflammatory findings, 27.59% were LSIL, 3.45% were ASCUS, and 1.72%HSIL. Conclusion. The uptake of cervical cancer screening falls within the global range despite it being low. The patterns on pap smear dictate the majority being normal followed by inflammatory changes then low grade changes then other findings. Being of a rural residence, HIV positive and having two or more sexual partners confers a higher chance of screening for cervical cancer.
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Clinical Patterns and factors associated with early adverse outcome following surgery for acute appendicitis: A multicenter study.
(Kampala International University; Faculty of Cinical Medicine and Dentistry, 2023-10) Farhan Yusuf Sharif
Introduction Acute appendicitis is one of the most common causes of acute abdominal pain that requires surgical treatment. The surgery for appendicitis has been associated with significant morbidity in studies done in other countries. There is paucity of data on patterns, early adverse outcomes and factors associated with early adverse outcomes following surgery for appendicitis in Uganda, yet an understanding of these may be useful in improving early outcomes of patients managed for appendicitis in our setting; the reason this study was done. Methods This was a prospective observational cohort in which we assessed for early outcome following surgery for acute appendicitis at 4 regional referral hospitals in Uganda (Hoima, Jinja, Mubende and Fort Portal). The occurrence of complications during the admission period was documented as well as the length of hospital stay. The factors associated with the adverse outcomes were determined using Poisson regression in SPSS version 26. Results Of the 102 patients that underwent surgery for acute appendicitis in this study, majority were males 79(77.5%) with a mean age of 23.8(SD=12.5) years. Perforated appendix was seen in 26 (25.5%) of the study participants. Post-operative complications occurred in 21(20.6%) with the commonest being surgical site infection seen in 19(18.6%) of the study participants. The median length of hospital stay was 3(IQR=3-4) days with 43(42.2%) staying in hospital for more than 3 days. Presence of anemia (Hb<8) (aRR=1.376, CI=1.159-1.634, P=<0.001) and having a perforated appendix (aRR=1.263, CI=1.026-1.555, P=0.027) were independently associated with occurrence of complications while being HIV positive (aRR=1.379, CI=1.105-1.721, P=0.005) and having a perforated appendix (aRR=1.258, CI=1.019-1.554, P=0.033) were independently associated with prolonged hospital stay. Conclusion The proportion of patients with perforated appendix was high compared to other studies. The proportion of patients with complications was high with a big proportion of patients spending more than 3 days in hospital. Sensitization of the community about early presentation is still required in order to reduce the number of patients that present late, which will in turn reduce the risk of complications and length of hospital stay.
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Youths Livelihood Programme (Ylp) And Entrepreneurial Empowerment: A Study Of Nyendo Mukugwe Division, Masaka City, Uganda
(2026) Ssentamu Moses
The study investigated the Youth Livelihood Programme (YLP) and Entrepreneurial Empowerment in Nyendo Mukugwe Division, Masaka City, Uganda, guided by Human Capital Theory and Empowerment Theory, with objectives to investigate the effect of livelihood support components on entrepreneurial empowerment, to assess the effect of economic development outcomes on entrepreneurial empowerment and to examine the relationship between the effectiveness and efficiency of funds utilisation in the Youth Livelihood Programme and the level of entrepreneurial. Employing a mixed-methods case study with a descriptive design, it targeted 750 youth from 50 interest groups, sampling 261 via Yamane's formula and purposively selecting 14 key informants; data was collected 15 through structured questionnaires and interviews, analysed using SPSS for quantitative data (ensuring validity with CVI > 0.70 and reliability with Cronbach's Alpha > 0.70) and thematic analysis for qualitative insights. Findings indicated mixed effects, where productive assets and social support significantly boosted empowerment (regression coefficients 0.15 and 0.06, p < 0.05), but inadequate financial support and infrastructure (means 2.99 and 2.14) limited it; empowerment positively influenced economic outcomes like income (86% agreement, mean 4.18) and job creation (100% agreement, mean 4.19) in a bidirectional loop; funds utilization was efficient for goals (89% agreement, mean 3.91) yet hindered by delays in disbursement of funds (mean 2.46) and unclear repayment (mean 3.50), enabling 72.87% to start businesses. The study concluded that YLP promotes empowerment and economic growth despite systemic barriers, recommending increased funding, streamlined disbursement, enhanced mentorship, and infrastructure investment to foster sustainable entrepreneurship in peri-urban Uganda. The study recommended increasing funding, improving infrastructure, strengthening mentorship and financial literacy, and adopting digital tools for monitoring and accountability to ensure sustainability and long-term youth self-reliance.