kitovu health care complex po box 524

88 Pages·2010·0.68 MB·English

by  Personal Secretary

KITOVU HEALTH CARE
COMPLEX
P.O. BOX 524
MASAKA
In Christ We Serve
ANNUAL ANALYTICAL
REPORT
2008/2009
COMPILED BY
THE MEDICAL SUPERINTENDENT
KITOVU HOSPITAL
Kitovu Hospital Annual Report 2008/2009
Endorsement of Report
This annual analytical report for Kitovu Hospital covering the period 2008/2009
has been prepared by the management of Kitovu Hospital. I endorse that it
represents management’s views on the position of the hospital in the period under
report.
Sr. Scholastica Nakakawa
Chief Executive Officer
Kitovu Hospital
th
Date 30 October 2009
This is to acknowledge that I have received this annual analytical report for
Kitovu Hospital covering the period 2008/2009 I have read it and endorse its
authenticity and representative of the position of the hospital in the year under
report
Rev. Fr. Denis Ddamulira
Chairperson of the Board of Governors
th
Date 30 October 2009
Kitovu Hospital Annual Report 2008/2009 2
Kitovu Hospital Annual Report 2008/2009
TABLE OF CONTENTS:
Abbreviations: ……………………………………………………….………... 4 - 5

Executive Summary: ……..…………………………………………………..…. 6 - 9
Introduction: ……………………………………………………………….……. 10
The Hospital and its Environment: ………………………………………...…… 11-13
The Community and Health Status: …………………………………………….. 13-14
Health Policy and District Health services: ……………………………………………………....... 15-16
Governance and Management:…………………………………………….……... 17-20
Human Resource: ………………………………………………………..……… 21-26
Finance: ……………………………………………………………...……. 27
Activities:
Curative:
OPD: ……………………………………………………………..….…. 28-31
Wards:……………………………………………………..………. 32-41
Special Curative Services:
Tuberculosis: …………………………………………………….….…. 42
Obstetric Fistula Unit: ……………………………………….…….…... 43
PMTCT: ………………………………………………..………….…… 44-45
HIV Counselling and Testing/VCT: ……………………..….………. 46-50
Supportive:
Laboratory and Blood Bank: ……………………………...…………..... 50-53
Pharmacy: ……………………………………………………....……… 53-56
X – ray: …………………………………………………..………..…… 56-57
Ultrasound: ………………………………………………………....….. 57-58
Domestic Services: ……………………………………………….……. 58-63
Ambulance Services:……………………………………..…………..… 64
Pastoral Care and Social Care…………………………………………... 65-68
Preventive and Promotive Services:
Community Based Health Care & Nutrition Unit:…………………..…. 69-72
Kitovu Community Health Insurance Scheme: …………………….….. 72-77
Health Training Institution:
Laboratory Training School: ………………………………………………...….. 77-79
Conclusion: ………………………………………………………………..…… 80 -83
Future Plans: ……………………………………………………………..…... 83 -84
Acknowledgments: …………………………..…………….……….…… 84-86
Annexes:
HMIS: ……………………………………………………………………….…. i
Board of Governors: …………………………………………………………..... ii (a)
Members of the Finance and Planning Committee ………………….………..… (b)
Member of Management Team: ……………………………………………....… (c)
Kitovu Hospital Annual Report 2008/2009 3
Kitovu Hospital Annual Report 2008/2009
Hospital Staff form by end of Financial Year: ..…………………………..…..… iii
Comprehensive Financial Report: ……………….……………………….….…. iv
ABBREVIATIONS:
AIDS - Acquired Immune Deficiency Syndrome
ANC - Antenatal Care
APSO - Agency for personnel services overseas. (Since 04/05 is
BS - Blood Slide
C VD - Cerebrol - Vascular Accident
C.B.H.C - Community Based Health Care
CCF - Congestive Heart Failure
CHW - Community Health Workers
CPE - Clinical Pastoral Care
CS - Caesarian Section
DDHS - District Director of Health Services
DHO - District Health Offices
DHB - Diocesan Health Board
DM - Daughters of Mary
DM - Diebetes Mellitus
DOT - Direct Observation Treatment
E.D.P - Essential Drug Program
G.E - Gastroenteritis
GID - Gastrointestinal Disease
GYN - Gynaecology
HAART - Highly Active Antiretrovial Treatment
Hb - Hemoglobin
HCT - HIV counselling and Testing
HIV - Human Immune Virus
HSD - Health Sub District
Kitovu Hospital Annual Report 2008/2009 4
Kitovu Hospital Annual Report 2008/2009
HSSP - Health Sector Strategic Plan
HTN - Hypertension
IMR - Infant Mortality Rate
IV - Intravenous
KCHIS - Kitovu Community Health Insurance Scheme
LOS - Length of stay
MMM - Medical Missionaries of Mary
MMR - Maternal Mortality Rate
MRC - Medical Research Council
NGO - Non Government Organisations
NMHCP - National Minimum Health Care Package
NSSF - National Social Security Fund
O.T - Operating Theatre
OPD - Out patient Department
PMTCT - Prevention of Mother to Child Transmission
PNFP - Private Not for Profit
PTB - Pulmonary Tuberculosis
RTA - Road Traffic Accident
RTI - Respiratory Track Infection
STD - Sexually Transmitted Disease
T.T - Tetenus Toxoid
TASO - The AIDS Supportive Organisation
TB - Tuberculosis Bacillai
U.N.F.P.A - United Nations Family Population Association
UCBHFA - Uganda Community Based Health Financing Association
UCMB - Uganda Catholic Medical Bureau
UGX - Uganda Shillings
UK - United Kingdom
USA - United States of America
Kitovu Hospital Annual Report 2008/2009 5
Kitovu Hospital Annual Report 2008/2009
UTI - Urinary Tract Infection
VVF - Vesico Vaginal Fistula
1. EXECUTIVE SUMMARY:
Kitovu Hospital, established by the Diocese of Masaka, 54 years ago in Masaka District,
Uganda, is a two hundred bed (200) Private Not For Profit (PNFP) hospital, operating under
the umbrella organization of the Uganda Catholic Medical Bureau (UCMB).
Achievements that have been made in the year according to last year’s plan:
Achievements:
1. Revision of patients’ fees for both Medical and Surgical wards, Gyne cases and OPD was
done. Majority of patients were able to pay.
2. OPD utilization has increased by 14%. (5% higher than our expected number of patients.
Expected visits in a year is 30,000) There was some slight improvement in customer care
relationship and reducing on waiting time.
3. Review of staff establishment as well as making sure each department has adequate staff
was done.
4. New Ultra Sound machine is on the way from abroad.
5. Built of new Ash/placenta pit.
6. A Grinder for cutting and sharpening metals was brought though it got broken.
7. Preparation for starting an ARV’s and HIV clinic at the hospital is underway. Ten staff
have been trained in provision of comprehensive HIV/AIDS care.
8. The compound was tendered.
9. New colorimeter and water bath have been acquired for the lab.
10. Plans to start intensive neonatal unit has been completed. Funds have been secured.
11. Funds to buy one hospital vehicle has been secured, though we are still looking for more,
as 2 other hospital cars are in poor condition, plus all the cars of CBHC Programme are
very old.
12. The Blood Bank was relocated to a specious old classroom block which was renovated.
13. Refurbishment of laboratory staff hostels was done.
Failures:
1. No development plan for training staff for a year was made.
2. Solicit for funds for immunization for our staff against Hepatitis B, C and HIV prophlaxis;
after needle stick from HIV infected patients was not accomplished though discussions
were done about it.
Kitovu Hospital Annual Report 2008/2009 6
Kitovu Hospital Annual Report 2008/2009
3. Monitoring sepsis or maternity did not take root as we had to shift mothers about 2 times
during renovation this year.
4. Failed to increase number of isolation rooms at medical ward and to construct private
rooms due to lack of funds.
5. Failure to carry out major repair of the hospital fence so as to contain security problems.
6. Failure to build and renovate staff houses.
7. Failure to obtain some equipment of laboratory e.g. haematology machine.
8. Failure to have full time fistula Repair services.
9. Failure to separate causality from Out-patient Department.
10. Plan to revise terms and conditions between Kitovu Hospital and Nakasero National Blood
bank was not done.
11. The Budget was not well controlled
N.B Failure to achieve most of our plans was due to inadequate finance.
Other achievements:
1. We started camping sessions for Blood Bank which have boosted our blood supply.
2. Two more of our qualified midwives were properly trained for PMCT programme
3. New water reserve tank was constructed with the capacity of 55,000 litres
4. Installation of new stand alone photovoltaic solar system on Children’s Ward.
5. Refurbishment of the chemotherapy unit in Children’s Ward
6. Repair to the administration rain water collection tank.
7. New supply tanks: New polyfibre supply tanks and their towers were installed at the
Laboratory Tutors House and Walungi quarters to increase on the supply of water to
these houses.
8. Repairs to the existing two reserve tanks
Challenges:
1. High turnover of experienced nurses and Midwives due to low salary scales
compared to the government’s scale.
2. Kitovu hospital works as referral hospital but not facilitated as such by the
Government via PHC grant.
3. Working as a referral unit, raises the unit cost of managing patients yet PHC grant
is stagnant as well as increasing poverty level in the community.
Kitovu Hospital Annual Report 2008/2009 7
Kitovu Hospital Annual Report 2008/2009
4. Non-compliant with medicines many patients with tuberculosis disease and HIV
refuse to go to other Health facilities which provide continuation phase for PTB and
ART’s.
5. Inadequate Medical staff residences.
6. No causality department yet the biggest emergencies are ART’s
7. Inadequate isolation rooms and lack of private rooms on Medical Ward.
8. Need of renovation and expand of OPD, Pharmacy store, central store to meet the
increased demand of services.
9. The hospital vehicles are worn-out and need replacement.
10. Hospital Laboratory needs Automation machines to give more reliable results.
11. The hospital’s fence needs replacement to contain security problems.
12. Lack of Autoclave and Heamatology analyzer for the Laboratory.
Important recommendations and plan for the coming year:
Future Plans:
Short-term
1. Obtain heamatology analyzer so that we get more accurate results in heamatology.
2. Train more Lab Technician to improve on the service.
3. Mobilize funds so that we can provide free or subsidized immunization to all staff
against infectious disease e.g. Hepatitis B.
4. Solicit funds for fridges, microscopes and autoclave for laboratory.
5. Restructuring the CBHC Programme as the main donor is phasing out
6. Consider including Fansider and Septrin prophlexis in the antenatal package.
7. To install solar system at Maternity and Surgical wards.
8. Divide the staff on maternity ward into 2 groups one to remain on admission and
another to labour ward as to improve service on maternity ward.
9. To carry out Medical Audit every four months.
10. To honour the Budget and minimise costs and avoid wastage of resources.
11. Revise terms and conditions between Kitovu Hospital and Nakasero National Blood
Bank
12. Monitor and document on post caesarean infection rate and waiting time on OPD.
13. Segregate the data of FSB as per definition of UCMB
Kitovu Hospital Annual Report 2008/2009 8
Kitovu Hospital Annual Report 2008/2009
14. Separation of midwives in group one to concentrate on admission and ward another
group to concentrate on labour ward.
15. Closely to monitor drug prescription by the Clinicians.
16. Follow up waiting time every four months.
Long - term
17. Have a larger space for X-ray department.
18. Solicit Funds for new X-ray machines.
19. Increase OPD attendance by 5% (of targeted population of utilization)
20. Plan to intensify the sensitization of our donor targeted groups in order to curb
shortages of blood.
21. To carry out Medical Audit every four months.
22. Solicit funds for private and isolation rooms on Medical ward.
23. Look for ways to improve on our ANC services.
Below are the two tables showing some of the activities and services rendered to
the patients in the last five years
Table showing the General Performance in four years
Year 2005/2006 2006/2007 2007/2008 2008/2009
OPD 33504 27904 28547 32622
Attendance
Admissions 13067 10453 9003 11032
Deliveries 1470 1397 1179 1818
Antenatal 2150 1340 1844 1212
attendance
Immunizati 9185 6862 9232 11401
on
DPT3 793 (87%)
• There is an increase in all areas except Antenatal Attendance. (Most of admissions are on Children
and Maternity Wards.) DPT3 is 87% which is a good return.
Table showing other services rendered:
2004/2005 2005/2006 2006/2007 2007/2008 2008/2009
X-Ray 3,090 1,654 2,011 1821 1796
Ultra Sound Scan 831 525 - 222 834
Laboratory 86,965 61,372 64,696 51,966 55154
Psycho-social care & counselling 5,881 4,529 3,271 3,487 3830
Blood Transfusion 3,410 6,023 5,492 3,728 4878
Social work activities 3,330 4,182 3,917 3,927 3,946
Obstruct Fistula (VVF) 201 312 296 235 169
There is overall increase in all services except ANC, VVF repair. There were only 3 out of 4
VVF workshops done last year.
Kitovu Hospital Annual Report 2008/2009 9
Kitovu Hospital Annual Report 2008/2009
The decrease of ANC might be contributed to other facilities in the area such as Government
hospital, private clinics but also there is need to study and improve our ANC services.
2. INTRODUCTION:
This annual report covers the period of July 2008– June 2009.
The source of data is from HMIS, hospital registers, hospital medical records and Masaka
Health District offices.
Trends of the hospital utilization are based on comparisons of the utilization indicators of 5
years. The number of patients getting services are increasing; expenditure continues to be high
but income is going down; this puts the future existence of the hospital in jeopardy.
This report tries to convey the hospital situation i.e. its location, environment, governance,
activities, achievements, challenges and future plans.
Presently, the hospital has adequate number of medical doctors with experience and Clinical
Officers only one with enough experience but others are newly qualified.
The number of midwives and nurses is also adequate; though the majorities are newly qualified
with little experience.
The expenditure is high and income is going down.
The key types of information this report tries to bring out, will translate what the present trends
mean and be able to predict the future trends.
Methods of assessment of compliance are with faithfulness to the mission in terms of
accessibility, equality and efficiency have been done using the standard unit of output (SUO)
and quality indicators (fresh still birth rate, maternal death rate and percentage of qualified
staff).
Some of the problems experienced in writing this report was getting the correct information in
time. Thus giving feedback to the staff will be priority in future.
Inspite of the difficulties and limitations, we hope that our readers will find this document
useful. We thank our readers e.g. UCMB for their feedback and we humbly request others to
do the same so that we can improve our services.
Any feedback and corrections are therefore highly appreciated.
Kitovu Hospital Annual Report 2008/2009 10