Quality of care plays an important role in the status of tuberculosis (TB) control, by influencing timely diagnosis, treatment adherence, and treatment completion. In this study, we aimed at establishing the quality of TB service care in Kamuli district health care centres using Donabedian structure, process, and outcomes model of health care. A cross-sectional study was conducted in 8 health care facilities, among 20 health care workers and 392 patients. Data was obtained using face-to-face interviews, an observation guide, a check list, and record review of the TB unit and laboratory registers. Data entry and analysis were done using EPI INFO 2008 and STATA 10 versions, respectively. A high number 150 (87.21%) of TB patients were not aware of all the signs to stop TB medication, and 100 (25.51%) patients received laboratory results after a period of 3–5 working days. The major challenges faced by health workers were poor attitude of fellow health workers, patients defaulting treatment, and fear of being infected with TB. One of the worst performance indicators was low percentage of cure. Comprehensive strengthening of the health system focusing on quality of support supervisions, patient follow up, promoting infection control measures, and increasing health staffing levels at health facilities is crucial.

BackgroundQuality of intrapartum care is an important intervention towards increasing clients’ utilization of skilled attendance at birth and accelerating improvements in newborn’s and maternal survival and wellbeing. Ensuring quality of care is one of the key challenges facing maternal and neonatal services in Uganda. The study assessed quality of intrapartum care services in the general labor ward of the Mulago national referral and teaching hospital in Uganda from clients’ perspective.MethodsA cross sectional study was conducted using face to face interviews at discharge with 384 systematically selected clients, who delivered in general labor ward at Mulago hospital during May, 2012. Data analysis was done using STATA Version (10) software. Means and median general index scores for quality of intrapartum care services were calculated. Linear regression models were used to determine factors associated with quality of care.ResultsOverall, quality of intrapartum care mean index score was 49.4 (standard deviation (sd) 15.46, and the median (interquartile range (IQR)) was 49.1 (37.5–58.9). Median index scores (IQR) per selected quality of care indicators were; dignity and respect 75 (50–87.5); relief of pain and suffering 71.4 (42.8-85.7); information 42.1 (31.6-55.3); privacy and confidentiality 33.3 (1–66.7); and involvement in decision making 16.7 (1–33.3). On average, higher educational level (college/university) (β: 6.81, 95% CI: 0.85-15.46) and rural residence of clients (β: 5.67, 95% CI: 0.95-10.3) were statistically associated with higher quality scores.ConclusionThis study has revealed that quality of intrapartum care services from clients’ perspective was low. Improvements should be focused on involving clients in decision making, provision of information about their conditions and care, and provision of privacy and confidentiality. There is also need to improve the number and availability of health care providers in the labor ward.

propofol in critically ill patients, and subsequently determining the best strategy for administering propofol. Methods: Costs of propofol-related infection and the different strategies of administration of propofol were computed according to the literature and microcosting method. The additional length of stay in ICU due to major infections related to propofol administration was estimated using the disability model, assuming a cost of CHF 2'118/intensive care unit day (local cost). The cost of each strategy was estimated based on all costs and on the probability of major infections related to propofol administration. Results: According to the links found in the literature by genotyping bacteria (syringe-patient), we assumed that a patient has a mean 22.6% risk of developing an infection by a contaminated preparation of propofol. Thus, the ready-to-use syringe and syringes drawn from vials have an infection probability of 0.

care seekers during the second trimester (OR:.82; 95%CI:.68-.99) and third trimester of pregnancy (OR:.50, 95%CI:.39-.64) were less likely to deliver in healthfacilities. ConClusions: Socio-demographic factors: Male headed households, age bracket 20-39 or 40-49, no education, and residence in rural Uganda, was associated with delivering outside health facility. Personal health practices and behaviors: first antenatal visit in second or third trimester of pregnancy was associated with delivering outside health facility.