Assessment of operational performance of health sub districts in Mubende district, Uganda.
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INTRODUCTION: In 2001, the government of Uganda through its health policy introduced health sub districts (HSDs) with the aim of bringing health services near the people. OBJECTIVE OF THE STUDY: The overall objective was to assess the operational performance of health sub districts. METHODOLOGY: The study was a cross sectional study RESULTS: The results show low staffing levels of 43.2% of the approved posts and it is chiefly caused by low pay of health workers. Prompt salary payment was the main motivator at health facilities. Only one HSD has a doctor. Health facilities do not offer services to the required service standards. The utilization of services was low compared to the national indicators, OPD utilization was 80%, Immunization coverage was 84% and supervised deliveries 20%. Supervision is crisis oriented and the chief constraint is lack of facilitation. Planning is based on demands from the centre. Plans for outreaches were lacking in 8 out of 20 the health units. Only 10 out of 20 health units had adequate drug store while while 6 0ut of 20 health units had properly kept stock cards. The overall level of operational performance of HSDs was 31.7% against the minimum level of operation of 50%. CONCLUSION AND RECOMMENDATIONS: Generally the performance of the HSDs is inadequate. The central government should fully decentralize funding and increase on the remuneration of health workers. Newly recruited staff of HSDs should be oriented in their new responsibilities especially in planning and support supervision. Health management committees of each health unit should be involved in all aspects pertaining to the operations of that health unit.
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