Background: Blood donation is the voluntary withdrawal of blood from an individual, after undergoing some medical screening in order to ensure the safety of both the donor and the recipient. Blood donation is crucial and indispensable in the medical process of saving lives. Globally, 112.5 million blood donations were made in 180 countries in 2013. Uganda needs at least 340,000 units of safe blood annually, but usually, only 200,000 units are collected yearly. Although massive blood donation campaigns are carried out to obtain blood, there is still more demand for blood within hospitals. Student populations are considered healthy, active, and receptive, thus, regarded as potential blood donors. This study sought to explore the barriers to blood donation among MUST students. Methodology: A qualitative descriptive design was used in this study. A purposive sampling method was used to select respondents from different faculties at MUST. Four FGDs were employed in the study and data were collected using a focus group discussion guide. Inductive content analysis was used to analyze data. Results: The study revealed different barriers to blood donation among students. Three broad themes were generated from the analysis; personal barriers related to blood donation, socio-cultural variations affecting blood donation, and the barriers concerning the blood donation process. Conclusion and recommendations: Although participants reported willingness to donate blood, it was found to be affected by barriers ranging from individuals related to the system/process in which blood is collected. Addressing these barriers may improve blood donation by MUST students.
Background The safety attitudes questionnaire (SAQ) short form (2006) is important for assessing patient safety culture in clinical environments. However, little is known about its validity and applicability in Uganda. This study validated the SAQ short form (2006) for use in assessing patient safety culture in critical care settings of hospitals in the Ugandan context. Methods Using a sequential exploratory mixed-methods research design, the face, content and construct validity for the SAQ short form (2006) was assessed in a multi-phased approach. A panel of eight (8) purposively selected experts assessed the face and content validity in rounds 1 and 2, respectively, while construct validity was assessed in round 3 using data from a cross-sectional survey of 256 frontline health workers in critical care settings of the selected hospitals. Analysis of survey data followed confirmatory factor analysis. Cronbach’s alpha examined internal reliability. Results Of the 36 items in the tool’s original version, 33 were rated clear, with a score of 100% on face validity. The use of contextual vocabulary and formatting issues arose as concerns. The S-CVI/ Ave was 100%, and S-CVI/ UA was 86.1%. Four new items added on effective communication as another dimension of patient safety culture. The survey had KMO=0.8605, the a priori-based model had a scale Cronbach’s alpha=0.8881, with unsatisfactory goodness of fit (RMSEA=0.051, 90% CI: 0.044–0.057, p close=0.427; chi-square=694.28, p <0.001; CFI=0.884, TLI=0.871). The modified final model had a scale Cronbach’s alpha =0.8967 and satisfactory goodness of fit (RMSEA=0.030, 90% CI: 0.019–0.039, p close=1.000; chi-square=424.98, p =0.002; CFI=0.966, TLI=0.960). Conclusion In the tool’s original form, the face validity was lacking despite satisfactory scores on item clarity. Content validity was adequate, while construct validity required modifications in construct specifications. Reliability was adequate before and after specification modifications. The modified version has adequate psychometric properties for Uganda.
Drug utilization Research (DUR) is important for improvement of patient management, optimal utilization of national pharmaceutical budgets and policy formulation. 1 As a result, DUR is strongly encouraged. 2 It includes studies on: marketing, distribution, prescription and use of drugs in a society, with special emphasis on social and economic benefits.Unfortunately, due to lack of coordinated actions for systematic DUR, 3 many resource-limited countries lack data on production, expenditure and consumption of pharmaceuticals. Conversely, this makes it difficult for policymakers and healthcare leaders to identify optimal entry points for targeted rational drug use interventions; depriving poor countries the opportunity to optimally utilize their national pharmaceutical budgets. The World Health Organization (WHO) and The International Network for Rational Use of Drugs (INRUD), in the early 1990s, developed and published a standard method for selected drug use indicators at health care facilities. These are given as: prescribing indicators, patient care indicators, facility indicators and complementary drug use indicators. The core prescribing indicators consist of the average number of drugs per prescription, proportion of patients prescribed antibiotics, proportion of patients prescribed injections, proportion of medicines prescribed by generic names and proportion of prescribed drugs from essential medicines list. 4
Purpose Antimicrobial resistance is now one of the leading five causes of death globally. This study evaluated the rationality of antibiotic prescriptions at lower primary care levels in three districts of Southwestern Uganda. Methods This prospective cross-sectional study reviewed 9899 antibiotic prescriptions at 39 health centers following a drug delivery cycle by National Medical Stores in three phases (19 days each on average). Phase 1 started 3 days after delivery, mid-way (Phase 2) and towards the end (Phase 3). The proportion of rationally prescribed antibiotics was determined using a modified criterion by Badar and in reference to Uganda Clinical Guidelines (UCG). Using multivariate logistic regression, the factors associated with rational prescription were determined with 95% confidence intervals. Results Seven of every 10 antibiotic prescriptions were irrational. Half the prescriptions were made by unauthorized personnel (nurses) and many of the pediatric prescriptions (916, 46.5%) did not bear body weight measurements to guide appropriate dosing. Also, the proportion of rational prescriptions in reference to UCG, 2016 was very low (3387, 34.2%). However, a high proportion of antibiotic prescriptions were legibly written (9462, 95.7%), prescribed by generic names (9083, 91.8%) and had a diagnosis (9677, 97.8%) indicated. Multivariate logistic analysis showed that; availability of medicines (phase 1) (phase 2 AOR=1.14, 95% CI:1.02–1.28, phase 3, AOR=1.23, 95% CI:1.1–1.38), legibly written prescription (AOR=0.61, 95% CI: 0.47–0.78), indication of a date on the prescription (AOR=0.56, 95% CI0.38–0.81) and being a medical officer were factors associated with rational antibiotic prescription. Conclusion We observed a high rate of irrational prescription in the study sites and the majority of these were by unauthorized personnel. A review of antibiotic use policies and focused interventions is crucial in these settings.
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