KITOVU HEALTH CARE COMPLEX P.O. BOX 524

94 Pages·2011·0.86 MB·English

by  Personal Secretary

KITOVU HEALTH CARE
COMPLEX
P.O. BOX 524
MASAKA
In Christ We Serve
ANNUAL ANALYTICAL
REPORT
2009/2010
COMPILED BY
THE MEDICAL SUPERINTENDENT
KITOVU HOSPITAL
Kitovu Hospital Annual Report 2009/2010
Kitovu Hospital Annual Report 2009/2010 2
Kitovu Hospital Annual Report 2009/2010
TABLE OF CONTENTS:
Abbreviations: ……………………………………………………….………... 4-6
Executive Summary: ……..…………………………………………………..…. 7-12
Introduction: ……………………………………………………………….……. 13
The Hospital and its Environment: ………………………………………...…… 14-16
The Community and Health Status: …………………………………………….. 17-18
Health Policy and District Health services: ……………………………………………………....... 19-20
Governance and Management:…………………………………………….……... 21-23
Human Resource: ………………………………………………………..……… 24-29
Finance: ……………………………………………………………...……. 30
Activities:
Curative:
OPD: ……………………………………………………………..….…. 31-35
Wards:……………………………………………………..………. 35-45
Special Curative Services:
Tuberculosis: …………………………………………………….….…. 46
Obstetric Fistula Unit: ……………………………………….…….…... 47
Chemotherapy: ………………………………………………………… 48
PMTCT: ………………………………………………..………….…… 48-49
HIV Counselling and Testing/VCT: ……………………..….………. 49-53
Supportive:
Laboratory and Blood Bank: ……………………………...…………..... 54-57
Pharmacy: ……………………………………………………....……… 57-60
X – Ray: …………………………………………………..………..…… 61-62
Ultrasound: ………………………………………………………....….. 62-63
Domestic Services/hospital projects:……………………………….……. 63-69
Pastoral Care and Social Care…………………………………………... 69-73
Preventive and Promotive Services:
Community Based Health Care & Nutrition Unit:…………………..…. 73-75
Kitovu Community Health Insurance Scheme: …………………….….. 76-81
Health Training Institution:
Laboratory Training School: ………………………………………………...….. 82-84
Conclusion: ………………………………………………………………..…… 85-89
Future Plans: ……………………………………………………………..…... 90-91
Acknowledgments: …………………………..…………….……….…… 92-94
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 2009/2010 3
Kitovu Hospital Annual Report 2009/2010
Hospital Staff by end of the 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
ASOT - Antistreptolysin O Titer
BS - Blood Slide
C VD - Cerebral - 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
CSF - Cerebral Spinal Fluid
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
ENT - Ear Nose Throat
GA - General Anaesthesia
G.E - Gastroenteritis
GID - Gastrointestinal Disease
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Kitovu Hospital Annual Report 2009/2010
GYN - Gynaecology
HAART - Highly Active Antiretrovial Treatment
Hb - Haemoglobin
HCG - Human Chorionic Ganadotropin
HCT - HIV counselling and Testing
HIV - Human Immune Virus
HSD - Health Sub District
HSSP - Health Sector Strategic Plan
HTN - Hypertension
IMR - Infant Mortality Rate
ISS - Immuno Supressed Syndrome
IV - Intravenous
KCHIS - Kitovu Community Health Insurance Scheme
LC - Local Council
LOS - Length of stay
LFT’S - Liver Function Tests
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
Kitovu Hospital Annual Report 2009/2010 5
Kitovu Hospital Annual Report 2009/2010
PUD - Peptic Ulcer Diseases
RTA - Road Traffic Accident
RA - Rheumatoid Arthritis
RTI - Respiratory Track Infection
SCT - Sickle Cell Test
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
UTI - Urinary Tract Infection
VVF - Vesico Vaginal Fistula
WCC - White Cell Count
Kitovu Hospital Annual Report 2009/2010 6
Kitovu Hospital Annual Report 2009/2010
1. EXECUTIVE SUMMARY:
Kitovu Hospital was established by the Diocese of Masaka, about 55 years ago in Masaka
District, Uganda. It is a two hundred (200) bed, 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:
We managed to:-
1. Solicit funds for fridges, microscopes and autoclave for laboratory.
2. Restructure the CBHC Programme as the main donor phased out
3. Install a solar system at Maternity ward.
4. Increase staff salaries so as to match with government salary scales; especially for
the Enrolled Nurses and Midwives.
5. Monitor and document post caesarean infection rate and waiting time on OPD.
6. Segregate the data of FSB as per definition of UCMB
7. Separate midwives in two groups one to concentrate on admission and another
group on labour ward.
8. Closely monitor drug prescription by the Clinicians.
9. Hire a Laboratory Technologist so as to improve on the quality of the service.
10. Regularly monitor sepsis on maternity ward.
11. Acquire a new double cabin-truck as a donation from Netherlands.
12. Conduct a two day capacity building workshops for all staff held on alternative days
Failures:
We failed to:-
1. Obtain heamatology analyzer so as to get more accurate results in heamatology.
2. To include Fansider and Septrin prophlexis in the antenatal package.
3. Carry out regular Medical Audit.
4. Revise terms and conditions between Kitovu Hospital and Nakasero National Blood
Bank.
5. Put in place development plan for training of staff in the year we have just ended.
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Kitovu Hospital Annual Report 2009/2010
6. Solicit for funds for immunization for our staff against Hepatitis B, C and HIV
prophlaxis; after needle prick from HIV infected patients, though discussions were held
about it.
Other achievements:
1. Comprehensive Nurse Students from Villa Maria were added on the work force of
Kitovu Hospital.
2. All the four qualified staff midwives that work in ANC had a two days workshop to
orient them with basic knowledge on family planning and to enable them provide
accurate F/P information and specifically natural F/P methods to couples that need it.
3. Engender Health sponsored our hospital staff for a 3 days’ workshop on Process and
Tools for improving the Quality of Maternal Health services and another one week
workshop on Quality Supervision.
4. Two members of staff attended courses of an introduction to pastoral care giving.
5. Eight members of staff attended a one week course at Mildmay on HIV and a cost
centre workshop was given to our staff by UCMB
6. All laboratory staff have gone through a training for malaria diagnosis by Masaka
District in Collaboration with Stop Malaria of MOH.
7. We have recently opened a Care Point for Early Infant Diagnosis for exposed children
to HIV as a program of MOH..
8. We have established a room strictly for blood group and cross matching; fully equipped
with a fridge for blood, compatibility requisition forms and standard operating
procedures.
9. We have established a system of dispensing medicine per chart for inpatients as to curb
on the big bills of medicine.
10. One Junior Radiographer completed his study.
11. We have reconstructed/renovated the hospital maternity and Labour ward roofs and
ceiling.
12. We have constructed the premature unit and a new pit latrine for OPD.
13. We have renovated of the hospital general kitchen, hospital canteen building and the
hospital mortuary.
14. 5 Acres of coffee were planted as an income generating Project for the hospital.
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Kitovu Hospital Annual Report 2009/2010
15. A tree nursery project was also started as an income generating project.
16. Through Dr. Maura and Dr. Una a donation of a Container with medical and non
medical equipments was received from friends of Ireland.
17. An orderly central store is now in place.
18. With support of Dr. Una and friends Nutrition ward was re-painted and its Water
System repaired.
19. The Rotary Club of Guernsery donated two Theatre lights and one spot light.
20. We have reviewed and followed up the drafted activity plans for the different projects.
21. Phase 1 for the construction of the Hospital Chapel is now complete.
22. Through the Government, The Laboratory Training School received bursary funds for
11 students.
Challenges:
1. Kitovu hospital has quite limited resources compared to its needs and prices of
commodities on the market are steadily on increase..
2. Working as a referral unit/Hospital, raises the unit cost of managing her patients yet
PHC grant is never increased. Widespread poverty in the community is also another
challenge.
3. Lack of ART clinic and ARV’s is a challenge in that many patients put their trust in
Kitovu Hospital and when they are referred to other organizations for the services,
some of them refuse to go there.
4. No causality department yet the biggest emergencies are RTA’s
5. Lack of a second Surgeon to help our Senior Surgeon.
6. We do not have full time Surgeon or Gyneacologist for continuous obstetric fistula
repair whereas there are many women who need this service.
7. Staff attrition.
8. Inadequate staff residences for medical staff.
9. Resistance by some staff against the new system of dispensing medicine according to
charts has led to wastage of medicine and delay of medication for our patients.
10. The Nutrition unit now depends on friends who contribute towards food. And so, salary
of staff is a problem.
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Kitovu Hospital Annual Report 2009/2010
11. Unreliable UMEME power supply has caused the hospital’s generator to be
overworked. Then, huge electricity bills add to the problem.
12. The male medical ward is far from the nurses’ station, thus leading to a mix of sexes for
patients who need close observation.
13. Lack of immunization for lab staff against infectious diseases like Hepatitis B.
14. The hospital fence needs replacement so as to contain security problems.
15. Lack of free contrimazole prophlaxis treatment for HIV+ clients
16. Lack of equipment such as Intra-osseous cannulas, full range of paediatric B/P caffs,
complete set of otoscope/ opthalmoscope and suction machine on Children’s ward.
17. Very old x-ray machine which leads to a number of rejected x-rays.
18. The operating room for Ultra sound is quite small, dusty, hot and the roof needs repair.
19. The incinerator needs repair.
20. Lack of safety cabinet in Microbiology room.
21. Lack of computer in Laboratory.
22. Inadequate isolation rooms, lack of private rooms, and mixing of sexes on Medical
Ward for closer observation of the very sick.
23. Urgent need for renovation and expansion of OPD, Pharmacy store, central store so as
to meet the increased demand of services.
24. Non-compliance with medicines e.g. many patients with tuberculosis disease and HIV
refuse to go to other Health facilities that provide ART’s.
25. As for the Early Infant Diagnosis program, caregivers don’t come back for results even
when they are contacted on phone.
26. Self-sponsored laboratory students are unable to meet their school fees in time.
27. Extreme poverty among our clients, quite often make them fail to meet the hospital
bills.
28. Construction projects are constrained by lack of funds; like the hospital chapel, which
still needs a lot of funds to be completed.
29. There is absolutely need to provide the Nabulago farm with a constant and permanent
source of water especially for the piggery project.
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