Training needs for Ugandan primary care health workers in management of respiratory diseases: a cross sectional survey

Abstract

Background: Respiratory diseases are among the leading causes of morbidity and mortality in Uganda, but there is little attention and capacity for management of chronic respiratory diseases in the health programmes. This survey assessed gaps in knowledge and skills among healthcare workers in managing respiratory illnesses. Methods: A cross sectional study was conducted among primary care health workers, specialist physicians and healthcare planners to assess gaps in knowledge and skills and, training needs in managing respiratory illnesses. The perspectives of patients with respiratory diseases were also sought. Data were collected using questionnaires, patient panel discussions and review of pre-service training curricula for clinicians and nurses. Survey Monkey was used to collect data and descriptive statistical analysis was undertaken for quantitative data, while thematic content analysis techniques were utilized to analyze qualitative data. Results: A total of 104 respondents participated in the survey and of these, 76.9% (80/104) were primary care health workers, 16.3% (17/104) specialist clinicians and 6.7% (7/104) healthcare planners. Over 90% of the respondents indicated that more than half of the patients in their clinics presented with respiratory symptoms. More than half (52%) of the primary care health workers were not comfortable in managing chronic respiratory diseases like asthma and COPD. Only 4% of them were comfortable performing procedures like pulse oximetry, nebulization, and interpreting x-rays. Majority (75%) of the primary care health workers had received in-service training but only 4% of the sessions focused on respiratory diseases. The pre-service training curricula included a wide scope of respiratory diseases, but the actual training had not sufficiently prepared health workers to manage respiratory diseases. The patients were unsatisfied with the care in primary care and reported that they were often treated for the wrong illnesses. Conclusions: Respiratory illnesses contribute significantly to the burden of diseases in primary care facilities in Uganda. Management of patients with respiratory diseases remains a challenge partially because of inadequate knowledge and skills of the primary care health workers. A training programme to improve the competences of health workers in respiratory medicine is highly recommended.

Asthma in young children in Uganda: caregivers’ and healthcare workers’ understanding and practices in diagnosis and management. A FRESHAIR qualitative study

“…HCWs do not have su cient knowledge about asthma in children and as such, they are not able to assess the children presenting with respiratory symptoms appropriately. This is further supported by the ndings from a survey on primary care health workers' competencies that indicated that most of them were not comfortable to assess patients with chronic respiratory symptoms [14]. This study involved 3 medical doctors, 3 clinical o cers and 3 nurses.…”

“…However, underdiagnosis of asthma in young children is still a big problem worldwide and the reasons are not very clear. It could be related to low awareness and understanding of the disease among caregivers and health care professionals, sub-optimal clinical assessment of the children with respiratory symptoms [13][14][15] and over-diagnosis of pneumonia according to the guidelines on Integrated Management of Childhood Illnesses (IMCI) [16]. In Uganda, a study in a tertiary care hospital indicated that over 90% of children with asthma symptoms were primarily diagnosed with pneumonia and treated with antibiotics [5].…”

Factors Influencing Uptake of Prostate Cancer Screening among Men Aged 40 Years and Above in Kazo Town Council, Kazo District, Uganda: A Cross‐Sectional Study

“…For example, the average startup cost per new hospital construction, human resources, medicines, and medical equipment is estimated at UGX.31.3 billion [ 26 ]. Despite the efforts of the government to prioritize primary healthcare, newly created districts occur in a context of related and continuing challenges of shortages of the health workforce at all levels, particularly frontline workers to screen and manage NCDs [ 28 , 29 ]. Effective coordination and provision of quality health services in newly created districts are likely to benefit from the availability and use of reliable data on key service needs to inform appropriate decision-making.…”