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Gwaikolo C, Bodo B, Nabawanuka D, Mukiibi M, Seremba E, Muyinda P, Bakainaga A, Woldemariam YT, Moore CC, Ssekitoleko R. Impact of supportive supervision visits on the availability of World Health Organization infection prevention and control core components in health facilities in Southwestern Uganda. Infect Prev Pract 2024; 6:100355. [PMID: 38854705 PMCID: PMC11156696 DOI: 10.1016/j.infpip.2024.100355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 01/19/2024] [Accepted: 02/15/2024] [Indexed: 06/11/2024] Open
Abstract
Background In sub-Saharan Africa, the provision of infection prevention and control (IPC) measures are often limited by resource constraints. Aim To determine the association of supportive supervision activities with the availability of the WHO core components for IPC at health facilities in Southwestern Uganda. Methods We employed a before and after quality improvement study design. We conducted a baseline assessment of the availability of the WHO IPC core components and provided supportive supervision activities, which was followed by a second IPC assessment. We included health centers II-IV, which have increasing clinical care capacity, and regional hospitals. Findings Of 244 regional health facilities, baseline assessment occurred at 111 (45%) of which 23 (21%) were reassessed. The number of facilities in the Red (<70%) category for each core component stayed the same or decreased at each facility type, but there was an increase from five to six health center III facilities scoring Red (<70%) for PPE. The number of facilities in the Green (>85%) category for each core component stayed the same or was increased at each facility type, but there was a decrease from four to two health center III facilities scoring Green (>85%) for instrument processing. There was an increase in the median (interquartile range [IQR]) overall score for all facilities (65 [54-72] vs 75 [68-83], P=0.0001). Conclusion Supportive supervision activities were associated with improved availability of the core components of IPC at health facilities in Southwestern Uganda. PPE should be prioritized in health care facilities in Southwestern Uganda.
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Affiliation(s)
- Cozie Gwaikolo
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, USA
| | | | | | | | - Emmanuel Seremba
- College of Health Sciences, Makerere University, Kampala, Uganda
- Kiruddu National Hospital, Kampala, Uganda
| | - Paul Muyinda
- College of Education and External Studies, Makerere University, Kampala, Uganda
| | | | | | - Christopher C. Moore
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, USA
- Department of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
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Schnaubelt S, Garg R, Atiq H, Baig N, Bernardino M, Bigham B, Dickson S, Geduld H, Al-Hilali Z, Karki S, Lahri S, Maconochie I, Montealegre F, Tageldin Mustafa M, Niermeyer S, Athieno Odakha J, Perlman JM, Monsieurs KG, Greif R. Cardiopulmonary resuscitation in low-resource settings: a statement by the International Liaison Committee on Resuscitation, supported by the AFEM, EUSEM, IFEM, and IFRC. Lancet Glob Health 2023; 11:e1444-e1453. [PMID: 37591590 DOI: 10.1016/s2214-109x(23)00302-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 06/12/2023] [Accepted: 06/19/2023] [Indexed: 08/19/2023]
Abstract
Most recommendations on cardiopulmonary resuscitation were developed from the perspective of high-resource settings with the aim of applying them in these settings. These so-called international guidelines are often not applicable in low-resource settings. Organisations including the International Liaison Committee on Resuscitation (ILCOR) have not sufficiently addressed this problem. We formed a collaborative group of experts from various settings including low-income, middle-income, and high-income countries, and conducted a prospective, multiphase consensus process to formulate this ILCOR Task Force statement. We highlight the discrepancy between current cardiopulmonary resuscitation guidelines and their applicability in low-resource settings. Successful existing initiatives such as the Helping Babies Breathe programme and the WHO Emergency Care Systems Framework are acknowledged. The concept of the chainmail of survival as an adaptive approach towards a framework of resuscitation, the potential enablers of and barriers to this framework, and gaps in the knowledge are discussed, focusing on low-resource settings. Action points are proposed, which might be expanded into future recommendations and suggestions, addressing a large diversity of addressees from caregivers to stakeholders. This statement serves as a stepping-stone to developing a truly global approach to guide resuscitation care and science, including in health-care systems worldwide.
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Affiliation(s)
- Sebastian Schnaubelt
- European Resuscitation Council, Niel, Belgium; Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria; Department of Emergency Medicine, Antwerp University Hospital and University of Antwerp, Antwerp, Belgium.
| | - Rakesh Garg
- Department of Onco-Anaesthesia and Palliative Medicine, Dr Braich All India Institute of Medical Sciences, New Delhi, India
| | - Huba Atiq
- Department of Anaesthesiology, Centre of Excellence for Trauma & Emergency, The Aga Khan University Hospital, Karachi, Pakistan
| | - Noor Baig
- Department of Emergency Medicine, Centre of Excellence for Trauma & Emergency, The Aga Khan University Hospital, Karachi, Pakistan
| | - Marta Bernardino
- Centro de Simulacion, Hospital Universitario Fundacion Alcorcon, Madrid, Spain; Spanish Society of Anaesthesiology and Intensive Care, Madrid, Spain
| | - Blair Bigham
- Department of Anesthesia, Division of Critical Care, Stanford University, Palo Alto, CA, USA
| | | | - Heike Geduld
- Division of Emergency Medicine, Stellenbosch University, Cape Town, South Africa
| | | | - Sanjaya Karki
- Department of Emergency and Pre-hospital Care, Mediciti Hospital, Bhaisepati, Lalitpur, Nepal
| | - Sa'ad Lahri
- Division of Emergency Medicine, Stellenbosch University, Cape Town, South Africa
| | - Ian Maconochie
- Department of Paediatric Emergency Medicine, Imperial College Healthcare Trust, London, UK
| | - Fernando Montealegre
- Department of Anaesthesiology, José Casimiro Ulloa Emergency Hospital, Peruvian Resuscitation Council, Lima, Peru
| | | | - Susan Niermeyer
- Department of Pediatrics, Section of Neonatology, University of Colorado School of Medicine and Colorado School of Public Health, Aurora, CO, USA
| | - Justine Athieno Odakha
- Department of Emergency Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Jeffrey M Perlman
- Department of Pediatrics, Division of Newborn Medicine, New York Presbyterian Hospital, Weill Cornell Medicine, NY, USA
| | - Koenraad G Monsieurs
- European Resuscitation Council, Niel, Belgium; Department of Emergency Medicine, Antwerp University Hospital and University of Antwerp, Antwerp, Belgium
| | - Robert Greif
- European Resuscitation Council, Niel, Belgium; University of Bern, Bern, Switzerland; School of Medicine, Sigmund Freud University Vienna, Vienna, Austria
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Characteristics and Injury Patterns of Road Traffic Injuries in Urban and Rural Uganda-A Retrospective Medical Record Review Study in Two Hospitals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147663. [PMID: 34300111 PMCID: PMC8304504 DOI: 10.3390/ijerph18147663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 07/14/2021] [Accepted: 07/16/2021] [Indexed: 11/17/2022]
Abstract
In the ongoing Second Decade of Action for Road Safety, road traffic crashes pose a considerable threat especially in low-income countries. Uganda shows a vast burden of non-fatal injuries and resides at the top range of countries with the highest death rates due to unsafe roads. However, little is known about the differences in road traffic associated injuries between urban and rural areas and potential influence factors. Here, we used a cross-sectional study conducted by a retrospective medical record review from trauma cases admitted in 2016 to hospitals in rural and urban areas in Uganda. Injury severity scores were calculated and descriptive analysis was carried out while multivariate logistic regression was applied to assess significant covariates. According to the 1683 medical records reviewed, the mean age of trauma patients in the dataset under investigation was 30.8 years with 74% male. The trauma in-hospital mortality was 4% while prevalence of traumatic injuries is 56.4%. Motorcycle users (49.6%) and pedestrians (33.7%) were identified as the most vulnerable groups in both urban and rural setting while mild injuries of extremities (61.6%) and the head/neck-region (42.0%) were registered most. The frequency of road traffic injuries was homogenous in the urban and rural hospitals investigated in this study; interventions should therefore be intensified ubiquitously. The identification of significant differences in road traffic crash and injury characteristics provides the opportunity for specific programmes to decrease the socio-economic and health burden of unsafe roads. In addition to law enforcement and introduction of a Systems Thinking approach to road safety including infrastructural and educational concepts, the strengthening of trauma care and health resources is recommended.
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