District Health Officer Perceptions of PEPFAR’s Influence on the Health System in Uganda, 2005-2011

نویسندگان

  • Nathaniel Lohman
  • Amy Hagopian
  • Samuel Abimerech Luboga
  • Bert Stover
  • Travis Lim
  • Frederick Makumbi
  • Noah Kiwanuka
  • Flavia Lubega
  • Assay Ndizihiwe
  • Eddie Mukooyo
  • Scott Barnhart
  • James Pfeiffer
چکیده

BACKGROUND Vertically oriented global health initiatives (GHIs) addressing the HIV/AIDS epidemic, including the President's Emergency Plan for AIDS Relief (PEPFAR), have successfully contributed to reducing HIV/AIDS related morbidity and mortality. However, there is still debate about whether these disease-specific programs have improved or harmed health systems overall, especially with respect to non-HIV health needs. METHODS As part of a larger evaluation of PEPFAR's effects on the health system between 2005-2011, we collected qualitative and quantitative data through semi-structured interviews with District Health Officers (DHOs) from all 112 districts in Uganda. We asked DHOs to share their perceptions about the ways in which HIV programs (largely PEPFAR in the Ugandan context) had helped and harmed the health system. We then identified key themes among their responses using qualitative content analysis. RESULTS Ugandan DHOs said PEPFAR had generally helped the health system by improving training, integrating HIV and non-HIV care, and directly providing resources. To a lesser extent, DHOs said PEPFAR caused the health system to focus too narrowly on HIV/AIDS, increased workload for already overburdened staff, and encouraged doctors to leave public sector jobs for higher-paid positions with HIV/AIDS programs. CONCLUSION Health system leaders in Uganda at the district level were appreciative of resources aimed at HIV they could often apply for broader purposes. As HIV infection becomes a chronic disease requiring strong health systems to manage sustained patient care over time, Uganda's weak health systems will require broad infrastructure improvements inconsistent with narrow vertical health programming.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

District Health Officer Perceptions of PEPFAR’s Influence on the Health System in Uganda, 2005-2011

Background Vertically oriented global health initiatives (GHIs) addressing the HIV/AIDS epidemic, including the President’s Emergency Plan for AIDS Relief (PEPFAR), have successfully contributed to reducing HIV/AIDS related morbidity and mortality. However, there is still debate about whether these disease-specific programs have improved or harmed health systems overall, especially with respect...

متن کامل

Experiences of seeking Antenatal Care and Delivery among teenagers at health facilities in Kibuku District, Eastern Uganda

Background: Uganda is ranked 14th out of 54 countries in Africa with the highest levels of teenage pregnancies. The teenage pregnancy rate in Kibuku District in 2016 was 35.8%, high above the average rate in Uganda (25%). It was also above the average for rural areas in Uganda (27%). Unfortunately, there is limited information on the experiences of seeking antenatal care and delivery among teen...

متن کامل

“Three Nooses on Our Head”: The Influence of District Health Reforms on Maternal Health Service Delivery in Vietnam

Background The impact of reorganisation on health services delivery is a recurring issue in every healthcare system. In 2005 Vietnam reorganised the delivery of health services at the district level by splitting preventive, curative, and administrative roles. This qualitative study explored how these reforms impacted on the organisation of maternal health service delivery at district and commun...

متن کامل

Does the Narrative About the Use of Evidence in Priority Setting Vary Across Health Programs Within the Health Sector: A Case Study of 6 Programs in a Low-Income National Healthcare System

Background There is a growing body of literature on evidence-informed priority setting. However, the literature on the use of evidence when setting healthcare priorities in low-income countries (LICs), tends to treat the healthcare system (HCS) as a single unit, despite the existence of multiple programs within the HCS, some of whic...

متن کامل

Implications of bride price on domestic violence and reproductive health in Wakiso District, Uganda.

OBJECTIVE Bride price payment is a gender issue with implications on gender relations in different socio-cultural contexts. It also impacts Sexual and Reproductive Health and Rights. In a qualitative study on the perceptions of domestic violence in Wakiso district, payment of bride price emerged as one of the key factors associated with domestic violence. The study explored experiences, motivat...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:

دوره 6  شماره 

صفحات  -

تاریخ انتشار 2016