Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Dec 18;8(1):17928.
doi: 10.1038/s41598-018-36249-8.

Measuring health facility readiness and its effects on severe malaria outcomes in Uganda

Julius Ssempiira  1   2   3 , Ibrahim Kasirye  4 , John Kissa  5 , Betty Nambuusi  1   2   3 , Eddie Mukooyo  5 , Jimmy Opigo  5 , Fredrick Makumbi  3 , Simon Kasasa  3 , Penelope Vounatsou  6   7
Affiliations

Measuring health facility readiness and its effects on severe malaria outcomes in Uganda

Julius Ssempiira et al. Sci Rep. .

Abstract

There is paucity of evidence for the role of health service delivery to the malaria decline in Uganda We developed a methodology to quantify health facility readiness and assessed its role on severe malaria outcomes among lower-level facilities (HCIIIs and HCIIs) in the country. Malaria data was extracted from the Health Management Information System (HMIS). General service and malaria-specific readiness indicators were obtained from the 2013 Uganda service delivery indicator survey. Multiple correspondence analysis (MCA) was used to construct a composite facility readiness score based on multiple factorial axes. Geostatistical models assessed the effect of facility readiness on malaria deaths and severe cases. Malaria readiness was achieved in one-quarter of the facilities. The composite readiness score explained 48% and 46% of the variation in the original indicators compared to 23% and 27%, explained by the first axis alone for HCIIIs and HCIIs, respectively. Mortality rate was 64% (IRR = 0.36, 95% BCI: 0.14-0.61) and 68% (IRR = 0.32, 95% BCI: 0.12-0.54) lower in the medium and high compared to low readiness groups, respectively. A composite readiness index is more informative and consistent than the one based on the first MCA factorial axis. In Uganda, higher facility readiness is associated with a reduced risk of severe malaria outcomes.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Geographical distribution of severe malaria outcomes in Uganda in 2013; (a) mortality, (b) severe cases.
Figure 2
Figure 2
Standard coordinates of readiness indicators on the first seven factorial axes (HCIIIs).
Figure 3
Figure 3
Standard coordinates of readiness indicators on the first five factorial axes (HCIIs).
Figure 4
Figure 4
Regional distribution of facility readiness score; (a) HCIIIs, (b) HCIIs.
See this image and copyright information in PMC

References

    1. Bhatt S, et al. The effect of malaria control on Plasmodium falciparum in Africa between 2000 and 2015. Nature. 2015;526:207–211. doi: 10.1038/nature15535. - DOI - PMC - PubMed
    1. World Health Organization. World malaria report: 2016 (2016).
    1. National Malaria Control Program. Uganda Malaria Operational Plan FY2016. Available at, https://www.pmi.gov/docs/default-source/default-document-library/malaria... (2016).
    1. Ssempiira J, et al. The contribution of malaria control interventions on spatio-temporal changes of parasitaemia risk in Uganda during 2009–2014. Parasit. Vectors. 2017;10:450. doi: 10.1186/s13071-017-2393-0. - DOI - PMC - PubMed
    1. WHO. The World Health Report 2000: Health Systems: Improving Performance. Public Health Rep. 2001;116:268–269.

Publication types