Incentives and barriers to implementing national hospital standards in Uganda.

OBJECTIVE The objective of this study was to elicit hospital staff's knowledge, attitudes, and current practices regarding hospital standards and to assess the level of motivation for staff and hospitals to meet new standards. DESIGN This was a qualitative study using in-depth interviews and focus group discussions with staff in four hospitals. There was no intervention. SETTING Four rural public and private not-for-profit hospitals in central Uganda. PARTICIPANTS Medical superintendents and other staff of four hospitals in Uganda who were familiar with the use of standards and had participated in a previous Uganda national accreditation program (Yellow Star). RESULTS All staff expressed strong support for the development and implementation of hospital standards, but also said they would need more recognition and ongoing motivation. They cited the need for technical assistance, funding, and training as the main obstacles. Key areas requiring standards were: infection control, cleanliness and hygiene, infrastructure and medical records. CONCLUSIONS There was strong support for the development and implementation of hospital standards. The main perceived obstacles to the implementation of hospital standards are resource limitations and technical capability. There is a need to develop and implement preliminary standards for hospitals in Uganda.