Browsing by Author "Robert K. Basaza"

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Delays in Diagnosis and Treatment of Pulmonary Tuberculosis in Patients Seeking Care at a Regional Referral Hospital, Uganda: A Cross Sectional Study
(BMC Research Notes, 2019) Winters Muttamba; Samuel Kyobe; Alimah Komuhangi; James Lakony; Esther Buregyeya; Eldad Mabumba; Robert K. Basaza
Objective: A cross-sectional survey involving 134 pulmonary TB patients started on TB treatment at the TB Treatment Unit of the regional referral hospital was conducted to ascertain the prevalence of individual and health facility delays and associated factors. Prolonged health facility delay was taken as delay of more than 1 week and prolonged patient delay as delay of more than 3 weeks. A logistic regression model was done using STATA version 12 to determine the delays. Results: There was a median total delay of 13 weeks and 110 (82.1%) of the respondents had delay of more than 4 weeks. Patient delay was the most frequent and greatest contributor of total delay and exceeded 3 weeks in 95 (71.6%) respondents. At multivariate analysis, factors that influenced delay included poor patient knowledge on TB (adjOR 6.904, 95% CI 1.648–28.921; p = 0.04) and being unemployed (adjOR 3.947, 95% CI 1.382–11.274; p = 0.010) while being female was found protective of delay; adjOR 0.231, 95% CI 0.08–0.67; p = 0.007). Patient delay was the most significant, frequent and greatest contributor to total delay, and factors associated with delay included being unemployed, low knowledge on TB while being female was found protective of delay.
Determinants of Willingness to Pay for Community Health Insurance Among Commercial Motorcyclists in Kampala City, Uganda: A Contingency Valuation Study
(Journal of Research & Health, 2022-03-01) Robert K. Basaza; Judith H. Kiconco; Elizabeth P. Kyasiimire; Emmanuel D. Otieno
Background: To assess determinants of Willingness to Pay (WTP) for Community Health Insurance (CHI) among commercial motorcyclists (Boda boda riders) in Kampala City, Uganda. Methods: This is a descriptive study with a cross-sectional design. A total of 381 commercial motorcyclists were selected from Nakawa Division using purposive and simple random sampling methods. Structured interviews and contingency valuation method were used for data collection and measuring WTP for CHI. Data were collected in April, May and June 2019. Data were analyzed in SPSS software, v. 21 by multivariate regression analysis and considering at significance level of P<0.05. Results: Most of Boda boda riders had WTP for CHI (70%); 7 out of 10 commercial motorcyclists were willing to pay a premium of at least 70,000 UGX (20 USD).Those with at least five years of experience in the commercial motorcycle business were 9 times more willing to pay for CHI. Those with hired motorcycles and a history of involvement in a riding accident were less likely to pay for CHI. The other key determinants of WTP included: Being a commercial motorcyclist for 3 years or more, being aware of CHI, self-employment (riding own motorcycle), a history of payment for any form of insurance, and being single. Conclusion: The WTP for CHI is high among commercial motorcyclists in Kampala City. The WTP among these motorcyclists is determined more by individual factors and less by insurance scheme-related factors. The results recommend the coverage of informal sector by CHI schemes to increase universal health coverage in Uganda
Experiences of Seeking Antenatal Care and Delivery Among Teenagers in Kibuku District, Uganda
(Journal Research & Health, 2022-07-01) Rebecca Namusana; Josephine M. Namyalo; Emmanuel D. Otieno; Robert K. Basaza
Background: Uganda is ranked 14 out of 54 countries in Africa with the highest level of teenage pregnancy. The teenage pregnancy rate in Kibuku District in 2016 was 35.8%, high above the average rate in Uganda (25%) and also above rural areas in Uganda (27%). Unfortunately, there is limited information on the experiences of seeking antenatal care and delivery among teenagers. This paper explored teenagers’ experiences seeking services at health facilities in the Kibuku district, Eastern Uganda. Methods: This study used a phenomenological design. Data were collected using in-depth interviews with 27 teenagers aged 14-19 years seeking antenatal care (ANC) or those who had delivered. The teenagers were purposively selected to participate in the study. Data collected was thematically and inductively analyzed through coding. Results: The study showed that most teenage mothers knew the importance of seeking ANC and delivery from a health facility. Unfortunately, few sought services early due to some experiences, including financial constraints, support from their caregivers (husbands and parents), medication, and health education. The teenagers were motivated to attend ANC and were treated well by health workers. However, most teenagers did not have the decision-making power to seek care. Conclusion: Teenage mothers knew the importance of seeking ANC and delivery at health facilities. Their experiences with the health facilities also contributed to the health-seeking behavior of the teenagers, including the comfort received by the girls at the facility, the medication administered, how they were treated by the health workers and the availability of utilities. Health and social workers could consider sensitizing teenagers and their caregivers about the delicate nature of their health when pregnant to make personal decisions.
Feasibility and Desirability of Scaling Up Community–Based Health Insurance (CBHI) in Rural Communities in Uganda: Lessons From Kisiizi Hospital CBHI Scheme
(BMC Health Sciences Research, 2020) Alex A. Kakama; Prossy K. Namyalo; Robert K. Basaza
Background: Community-based Health Insurance (CBHI) schemes have been implemented world over as initial steps for national health insurance schemes. The CBHI concept developed out of a need for financial protection against catastrophic health expenditures to the poor after failure of other health financing mechanisms. CBHI schemes reduce out-of-pocket payments, and improve access to healthcare services in addition to raising additional revenue for the health sector. Kisiizi Hospital CBHI scheme which was incepted in 1996, has 41,500 registered members, organised in 210 community associations known as ‘Bataka’ or ‘Engozi’ societies. Members pay annual premiums and a co-payment fee before service utilisation. This study aimed at exploring the feasibility and desirability of scaling up CBHI in Rubabo County, with specific objectives of: exploring community perceptions and determining acceptability of CBHI, identifying barriers, enablers to scaling up CBHI and documenting lessons regarding CBHI expansion in a rural community. Methods: Explorative study using qualitative methods of Key informant interviews and Focus Group Discussions (FGDs). Seventeen key informant interviews, three focus group discussions for scheme members and three for non- scheme members were conducted using a topic guide. Data was analysed using thematic approach. Results: Scaling up Kisiizi Hospital CBHI is desirable because: it conforms to the government social protection agenda, society values, offers a comprehensive benefits package, and is a better healthcare financing alternative for many households. Scaling up Kisiizi Hospital CBHI is largely feasible because of a strong network of community associations, trusted quality healthcare services at Kisiizi Hospital, affordable insurance fees, trusted leadership and management systems. Scheme expansion faces some obstacles that include: long distances and high transport costs to Kisiizi Hospital, low levels of knowledge about health insurance, overlapping financial priorities at household level and inability of some households to pay premiums. Conclusions: CBHI implementation requires the following considerations: conformity with society values and government priorities, a comprehensive benefits package, trusted quality of healthcare services, affordable fees, trusted leadership and management systems.
The Feasibility Analysis of Integrating Community-Based Health Insurance Schemes Into the National Health Insurance Scheme in Uganda
(PloS one, 2024-04-14) Prossy Kiddu Namyalo; Boniface Mutatina; Sarah Byakika; Aliyi Walimbwa; Rose Kato; Robert K. Basaza
Background Uganda has a draft National Health Insurance Bill for the establishment of a National Health Insurance Scheme (NHIS). The proposed health insurance scheme is to pool resources, where the rich will subsidize the treatment of the poor, the healthy will subsidize the treat- ment of the sick, and the young will subsidize the treatment of the elderly. However, there is still a lack of evidence on how the existing community-based health insurance schemes (CBHIS) can fit within the proposed national scheme. Thus, this study aimed at determining the feasibility of integrating the existing community-based health financing schemes into the proposed National Health Insurance Scheme. Methods In this study, we utilized a multiple–case study design involving mixed methods. The cases (i.e., units of analysis) were defined as the operations, functionality, and sustainability of the three typologies of community-based insurance schemes: provider-managed, community-managed, and third party-managed. The study combined various data collection methods, including interviews, survey desk review of documents, observation, and archives. Findings The CBHIS in Uganda are fragmented with limited coverage. Only 28 schemes existed, which covered a total of 155,057 beneficiaries with an average of 5,538 per scheme. The CBHIS existed in 33 out of 146 districts in Uganda. The average contribution per capita was estimated at Uganda Shillings (UGX) 75,215 = equivalent to United States Dollar (USD) 20.3, accounting for 37% of the national total health expenditure per capita UGX 51.00 = at 2016 prices. Membership was open to everyone irrespective of socio-demographic status. The schemes had inadequate capacity for management, strategic planning, and finances and lacked reserves and reinsurance. The CBHIS structures included promoters, the scheme core, and the community grass-root structures. Conclusion The results demonstrate the possibility and provide a pathway to integrating CBHIS into the proposed NHIS. We however recommend implementation in a phased manner including first providing technical assistance to the existing CBHIS at the district level to address the critical capacity gaps. This would be followed by integrating all three elements of CBHIS structures. The last phase would then involve establishing a single fund for both the formal and informal sectors managed at the national level.
The Handwashing Practices and Awareness Among Children in Primary Schools in Karongi District, Rwanda: What Strategies Can Promote Effective Handwashing Practices?
(Texila International Journal of Public Health, 2024-09-30) Theoneste Nteziryayo; Robert K. Basaza
Child mortality in Africa is a pressing issue, particularly due to diarrhea and respiratory tract infections. These diseases are often transmitted through improper handwashing practices. This research aimed to identify the factors that influence handwashing habits and assess the availability of adequate facilities and water sources in primary schools in the Karongi district. A mixed-method approach was used to collect data from 583 students through structured questionnaires and 120 teachers through semi-structured interviews. Additionally, interviews with parents and community members were conducted to gain broader insights into community hygiene practices and support systems. Quantitative analysis using SPSS showed that promoting handwashing among school children reduces illness and absenteeism. Over two-thirds (67.2%) of students reported receiving effective support from their teachers, and another two-thirds (66.7%) stated that they wash their hands with soap and water. Moreover, close to another two-thirds (64%) of students acknowledged the importance of hygiene in disease prevention, and nearly two-thirds (60.9%) were aware of the health risks associated with poor hygiene. Qualitative findings revealed that while primary schools have sufficient hygiene facilities, there are challenges such as water shortages, inadequate hygiene resources, a limited number of washing stations, and water supply shortages. The study concludes that it is crucial to promote handwashing through educational campaigns to reduce disease transmission and improve the health outcomes of school children in Rwanda. Additionally, it emphasizes the need to address resource challenges in primary schools.