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KITOVU HEALTH CARE COMPLEX P.O. BOX 524 PDF

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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 Kitovu Hospital Annual Report 2009/2010 4 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. Kitovu Hospital Annual Report 2009/2010 7 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. Kitovu Hospital Annual Report 2009/2010 8 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. Kitovu Hospital Annual Report 2009/2010 9 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. Kitovu Hospital Annual Report 2009/2010 10

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