INTRODUCTION The purpose of the study was to explore the factors affecting the quality of care to hospitalized patients of medical and surgical wards of Mulago Hospital. Specific factors like organizational factors, nurse related factors, environmental factors and patient related factors were examined. The sole purpose of conducting the study on these particular wards was to give recommendations to the management, health workers and stakeholders on how to improve the quality of service that is offered to these hospitalized patients. METHODOLOGY The study adopted a cross sectional study design. Qualitative and quantitative approaches of data collection were employed. A total of 288 participants and a focus group discussion of 10 patients constituted the sample size. These participants were selected from both medical and surgical wards using simple random sampling. Permissions were thought from the relevant authorities and consent was sought from patients before getting information from them. RESULTS The study revealed that availability of health workers, supplies and drugs were least scored with poor and fair with 21.89%, 13.19% and 14.94% respectively as organizational factors affecting quality of care. Confidentiality 44.45% and privacy 54.56% were identified as some of the organizational factors affecting quality of care with poor and fair scores. Congestion (43.40%), noise around the ward (34.38%) and untidy toilets and shower rooms (56.25%) were also identified as environmental factors affecting quality of care. It was also observed that most patients agreed that they come to the hospital with at least two care takers which brings about congestion on the ward. CONCLUSION This study revealed that there is no single factor affecting quality of care. There is interplay between the different factors affecting quality of care to hospitalized patients. These factors need intervention by the different stake holders so that a lasting solution can be made to overturn the global problem of poor quality of health service. RECOMMENDATION Mulago as an institution will institute a quality improvement team that can cautiously monitor quality services that are offered to the patients and settle some of the minor issues at the hospital level.

Introduction: The reduction in the incidence of diabetes is directly associated with change in lifestyle. Adherence to lifestyle modifications is a problem common with type 2 diabetic patients. According to International Diabetic Federation, of which Uganda is a member country, there are 400,600 people in Uganda registered with Diabetes Mellitus. The focus of the government in advancing free medical care and other support systems in Uganda has attained less success. The rising challenge of the condition remains a threat to the livelihood of the people Objectives: The aim of the study was to determine the factors associated with adherence to lifestyle modifications among type 2 diabetic patients attending Kiwoko hospital. The specific objectives were; to assess the individual factors, socio-economic factors and DM related complications associated with adherence to lifestyle modifications among type 2 diabetic patients attending Kiwoko hospital. Methodology: A cross-sectional study was conducted among 96 diabetes type 2 patients attending Kiwoko hospital in the period of June 2017. Data was collected using a researcher administered questionnaire from randomly selected patients and analyzed using SPSS were chi-square tests were conducted to determine the associations. Results: The proportion of patients that adhered to type 11 diabetes mellitus lifestyle modifications was 39.6%. Majority of the respondents had knowledge about lifestyle modifications and positive attitude towards adherence. The most practiced modifications were; dietary modifications (89.6%), attendance of DM clinics (89.6%) and abstinence from abuse of substances (84.4%). Two thirds of the respondents (45.8%) had emergency visits to the hospital due to uncontrolled sugar levels. Age (P=0.000), average monthly income (P=0.000), uncontrolled sugar levels (P=0.006) and damage to the eyes and nerves due to DM (P=0.000) had significant association with adherence to lifestyle modifications. Conclusion and recommendation: Low adherence to life style modifications among people with type 11 diabetes in Nakaseke District is significantly associated with, age, religion and income status. Dietary modifications, regular monitoring of blood sugar levels, self-care behavior and abstinence from substance abuse are significantly associated with complications such as diabetic foot uncontrolled sugar levels and damage to eyes and nerves. A multi-disciplinary approach should be used to increase adherence to lifestyle modifications for type 11 diabetes.

Background: Utilization of maternity services by pregnant women reduces mortality rates. Indeed, women are encouraged to utilize maternity services as early as possible during pregnancy, delivery and pueperium because evidence shows that utilization of these services improves outcomes for women and their babies. This study sought to determine the factors affecting utilization of maternity services by pregnant women in Namulonge health center III, Wakiso district between January 2016 and July 2016. Methods: The study used a cross sectional design, utilizing quantitative data collection methods. 196 participants were enrolled in the study. A self-administered questionnaire was used to collect data and the study population consisted of women. (18-49 years). Simple random sampling method was used to select the study participants, statistical package for social sciences version (SPSS) 20.0 was used for data analysis Results: Bivariate analysis revealed that age P<0.001, as average monthly income P<0.026, availability of health workers P<0.007, attending maternity clinics P<0.040, affordability P<0.024, distance P<0.016, attendance of ANC clinics P<0.006, time taken to receive service P<0.021, attendance of PNC clinics P<0.022, desired place of delivery P<0.037, friendly health services P<0.008 and attitude of health workers P<0.037 were significantly associated with utilization of maternity services at the facility (P<0.05). Multivariate binary logistics regression revealed that the associated factors predicted 100% (Nagelkerke R-square=1.000) of the changes in utilization of maternity services among the respondents. Conclusion and recommendations: As health facilities are reimbursed by the government for the costs of maternity services, Additional factors including age groups, average monthly income, availability of health workers, attendance of maternity clinics, affordability of maternal services, distance to health centers, attendance of ANC clinics, time taken to receive health services, attendance of PNC, desired place of delivery, friendly health services, attitude of health workers should be addressed by policy makers by increasing on the human resources for health and equipments used at the facilities. This will reduce on the waiting time and encourage mothers and their husbands to seek more maternal health services. Awareness of maternity benefit of utilizing health care maternity services Non-utilization or under utilization of the schemes is either due to lack of awareness or poor accessibility.

The study was entitled “risk factors associated with hypertension among adults attending outpatient clinic in Masaka regional referral hospital”. According to the World Health Organization (WHO, 2009), 13% of all deaths globally to high blood pressure making it an area of prime importance for public health in both developing and developed nations. Based on the objectives of examining the socio-demographic risk factors, establishing the individual risk factors as well as identifying the lifestyle risk factors associated with hypertension among patients attending OPD at Masaka Regional Referral hospital, the study aimed at determining the risk factors associated with hypertension among adults attending OPD in Masaka regional referral hospital. Existing literature for different authors was reviewed to identify disagreements and disagreements therein. This was a case control study on 282 participants. To obtain the required sample of respondents, techniques of consecutive sampling technique where patients who met the required selection criteria were chosen consecutively until the required number of respondents was obtained. The required information was obtained by administering an interview rate questionnaire. Thereafter, the data was edited, sorted, coded and tabulated using SPSS version 20 to derive frequency tables, graphs and percentages. The findings from the study indicated that age, employment status and monthly income were statistically significantly associated with the occurrence of hypertension among the respondents. Furthermore, the study revealed that family history, stress, chronic illnesses, obesity and diabetes were all statistically significant individual risk factors for hypertension. However, the study did not find a thyroid disease as a significant risk factor. Moreover, alcohol consumption as well as excessive weight gain were also found out to be the most cited life style risk factors for hypertension among patients. Based on the study findings, the researcher proposed that health workers should create awareness among communities about the risk factors for hypertension; government should regulate alcohol consumption, health-educating people on the importance of eating balanced diets, physical exercises and discourage living a sedentary lifestyle. Government through the ministry of health should ensure that health facilities are well equipped with well-trained health workers who are able to diagnose and treat hypertensive patients.

Introduction: Poor eating habits is a major public health concern among young adults who experience transition into university life during which; they are exposed to stress and lack of time. Objectives: The aim of the study was to assess the factors affecting dietary patterns among students at International Health Sciences University. The objectives were; to determine the socio-demographic, individual and institutional related factors affecting the dietary patterns. Methodology: The study utilized a cross-sectional study design and comprised of 103 students from three faculties at the university. Data collection was by use questionnaires. Stratified random sampling technique and simple random sampling were used to obtain the participants. Results: Students with healthy diet/patterns (46.6%) were less than those with unhealthy diet/patterns and the healthy dietary patterns included; eating three or more meals a day (49.5%), taking breakfast before classes (64.1%), taking 4 or more glasses of water per day (60.2%), not skipping meals (25.2%), not consuming fats often (87.4%), considering a balanced diet while making food choices (7.8%) and consuming fruits and vegetables. Availability of favourite food within reach (P=0.032), availability of fruits and vegetables within reach (P=0.038) and food consumed at the food courts around campus (P=0.000) had significant association with the dietary patterns of students. Conclusion and recommendation: 53.4% had unhealthy diet/patterns with the major unhealthy dietary patterns being; not considering a balanced diet while making food choices (92.2%) and skipping meals (74.8%). The major reasons for skipping meals are lack of financial funds and busy schedule. According to the findings, it is recommended that students should be educated about healthy eating behaviours and their benefits.

Background: Strict adherence to antiretroviral therapy (ART) is key to sustained HIV suppression, reduced risk of drug resistance, improved overall health, quality of life, and survival, as well as decreased risk of HIV transmission. Non-adherence to ART can lead to poor clinical, immunological, and virology outcomes. At an individual level, the outcome of non-adherence includes incomplete viral suppression, continued destruction of the immune system, decrease of CD4+ cell count, progression of disease, emergence of resistant viral strains, limited future therapeutic option, and higher costs for individual treatment. These outcomes all translate to higher ART program cost Objective: The purpose of study was to determine the factors influencing adherence to antiretroviral therapy among HIV positive patients attending ART clinic at Bugono health center IV Methods: This was a cross-sectional and descriptive in nature, employing quantitative method of data collection was used to assess factors affecting ART adherence among 283 HIV positive patients at Bugono health center IV using simple random sampling, data was analyzed using SPSS version 20. Results: From the data analyzed, the level of adherence was low at 62.9Marital status (ᵡ2=13.538, P-value of 0.004), level of education (ᵡ2=86.162, P-value of 0<.001), occupation (ᵡ2=12.909, P-value of 0.005), residence (ᵡ2=10.686, P-value of 0.001), financial status (ᵡ2=8.462, P-value of 0.004), distance to health facility (ᵡ2=5.685, P-value of 0.017), availability of drug at the health Centre (ᵡ2=5.946, P-value of 0<.001), availability of health workers (ᵡ2=28.062, P-value of 0<.001), attitude of health workers (ᵡ2=36.525, P-value of 0<.001), waiting time (ᵡ2=40.219, P-value of 0<.001), frequency of hospital visits (ᵡ2=22.342, P-value of 0.00), counselling services (ᵡ2=40.792, P-value of 0<.001), Frequency of refill (ᵡ2=7.949, P-value of 0.005), effect of side effect (ᵡ2=32.329, P-value of 0<.001), accessibility of ART (ᵡ2=6.826, P-value of 0.009) and number of pills (ᵡ2=13.783, P-value of 0<.001) were with significantly associated with adherence to ART in the study Conclusions and Recommendations: In conclusion, this study revealed that the level of adherence was low. Therefore the study recommends that health care providers should regularly counsel and educate patients before initiation and during the course of antiretroviral therapy and Health care providers should enhance their interpersonal interaction with their patients to appropriately deliver messages about the HIV disease and HIV medications, to build a trusting relationship and encourage patients to ask questions about their treatment and discuss challenges of taking ARV medications.

The study was about establishing factors that influence the performance of Village Health Teams in Moroto in the management of childhood illness in the current project of Integrate Community Case Management (ICCM). The main objective was to assess Village Health Teams‟ performance in the management of childhood illness in Karamoja, and suggest recommendation for gaps identified. Specific Objectives of the study were to assess the influence of training of VHTs in management of childhood illness; to analyse the effect of supervision of VHTs in management of childhood illness; and to assess the influence of facilitation / motivation of VHTs in the management of childhood illness in Moroto district. Methodology: A cross sectional study was conducted in the current Moroto and Napak districts. Ten Sub-Counties were sampled and a total of 121 respondents were sampled. These included the 54 respondents for the questionnaires, 12 key informants 15 caretakers and 40 persons in four focus group discussions. Data was analysed using the SPSS computer data analysis application. Key findings: The study revealed that communities appreciated the services of the VHTs; however, poor motivation, inadequate supervision from health workers and low literacy levels among the VHTs influence their performance in the management of childhood illness. Conclusion: The study concluded that the VHT‟s services in the villages are very important and appreciated by the community. VHT performance can be boosted if the incentive / transport allowance is increased; adequate supervision and coaching is provided and constant drug supply is ensured.

Introduction: These pre-analytical errors have been reported as the major pit hole in Pathology laboratory that affect the quality of reports as well as the management and prognosis of the patient. These errors constitute about 4-5 times of the errors compared to analytical and post-analytical processes. The work flow effectively involves three phases, pre-analytical, analytical and post-analytical in which all phases are interconnected directly or indirectly. The research study was done at the Pathology department, college of health sciences, Makerere University located in upper Mulago. The main objective of the study was to study Pre-analytical errors affecting the quality of the final results produced at Pathology laboratory. The specific objectives were to determine the rate of occurrence, commonest stage presenting with pre-analytical errors and to establish any association between pre-analytical errors and the quality of the final results produced at Pathology laboratory Makerere University College of Health Sciences. Methodology: The study looked at 323 laboratory request forms using a descriptive prospective research design in a period of three (3) months ranging from May to Aug 2018. Data was collected using observation checklist, entered into excess, analyzed and presented using frequency tables and bar charts. Results: The rate of occurrence of pre-analytical errors in the study was 100%. The commonest stage presenting with pre-analytical error was grossing not done by senior 316(97.83%), followed by grossing errors 312(96.59%) and the lowest was clinical summary 27(8.36%). There was no association between pre-analytical and TAT. Conclusion and recommendations: Pre-analytical errors occur frequently in pathology lab, there a strong association between pre-analytical errors especially demographic data, clinical history and grossing. Pathology laboratory should embrace SLIPTA in order to work towards accreditation in any of the accrediting bodies. There is a desperate need of senior pathologist during grossing and there is need to do monitoring and evaluation both in laboratories and clinical.

Poor helmet use has led to great head injury burden especially trauma and death after accidents. It is estimated that over one million people worldwide are injured or disabled due to poor helmet use (Chisholm et al, 2012). In Kabalagala Parish, many boda Boda cyclists either don‟t have helmets or poor use them which had resulted in injuries in case of accidents. Specific objectives of the study were; assessing the level of knowledge, attitude and practices of motorcyclist in Kabalagala Town towards helmet use in prevention of head injuries between 2010 and 2016. The adapted a cross-sectional research design where a sample size of 92 respondents who were boda boda cyclists selected by stratified and simple random sampling. Study findings showed that, out of the 92 respondents used in this study, majority had fairly good knowledge about helmet use where 66(72%) did not receive routine education about helmet use (0.0000), 64(70%) knew their uses, 53(58%) knew that a good helmet should have a string that is fastened at the chin, covers the whole head, hard enough and well ventilated (0.0000), 69(75%) thought that a helmet should only be cleaned when it gets dirty (P=0.0036). It was however found out that most 51(55%) of them never knew the life span of a helmet (P=0.0005) and 53(58%) did not know that the best sources of helmets (P=0.0001). Findings showed that, respondents had negative attitude because; 46(68%) carried diseases (P=0.0001), 54(59%) thought the helmets should be worn on ones wish or fashion (P=0.0000), helmets should be worn depending on weather conditions and hours of the day 64(70%) and riders do not appreciate that helmet is their own protection but not serving the law 75(82%) (P=0.0292). Respondents had poor practices where; only 52(56.5%) had helmets at the time of study, 57(62%) never regularly wore helmets, 75 (81%) never provided helmets to their passengers and 43 (46.7%) fastened their helmets before riding. In conclusion, respondents had good knowledge towards helmet use because they knew their uses and could define the characteristics of a good helmet. However they had poor attitude because they believed that they carried diseases, be worn on ones, wish or fashion and not for their own benefit but to serve the law. This could have led to poor practice since few had helmets and never regularly used them sometimes despite having them. The researcher suggests that, more education and sensitization be given to boda boda cyclists about helmet use and force them to observe the law through penalties.