Informal economic activities of public health workers in Uganda : implications for quality and accessibility of care.
This paper reports the results of a study in Uganda of the informal'economic activities of health workers, defined as those which earn incomes but fall outside official duties and earnings.
The study was carried out in 10 sub-hospital health facilities of varying size and intended role and used a variety of quantitative and qualitative methods.
The paper focuses on those activities which are carried out inside public health facilities and which directly affect quality and accessibility of care.
The main strategies in this category were the leakage of drug supply, the informal charging of patients and the mismanagement of revenues raised from the formal charging of patients.
Few of the drugs supplied to health units were prescribed and issued in those sites.
Most health workers who have the opportunity to do so, levy informal charges.
Where formal charges are collected, high levels of leakage occur both at the point of collection and at higher levels of the system.
The implications of this situation for the quality and accessibility of services in public health facilities were assessed.
Utilisation levels are less than those expected of the smallest rural units and this workload is managed by a handful of the expected staff complement who are available for a fraction of the working week.
Even given these few patients, drugs available after leakage were sufficient to cover less than half of those attending in most facilities. (...)
Mots-clés Pascal : Ouganda, Afrique, Epidémiologie, Evaluation, Homme, Santé, Qualité, Soin, Personnel sanitaire, Infirmier, Etude multicentrique, Questionnaire, Pratique professionnelle, Motivation, Prescription médicale, Utilisation, Extrahospitalier
Mots-clés Pascal anglais : Uganda, Africa, Epidemiology, Evaluation, Human, Health, Quality, Care, Health staff, Nurse, Multicenter study, Questionnaire, Professional practice, Motivation, Medical prescription, Use, Out of hospital
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0404861
Code Inist : 002B30A05. Création : 22/03/2000.