John Hans Wasswa | Uganda Management Institute (original) (raw)

Papers by John Hans Wasswa

Journal of Pharmaceutical Policy and Practice

Background Health supply chain is crucial for proper functioning of a health system and advancing... more Background Health supply chain is crucial for proper functioning of a health system and advancing national and international health security goals. The Coronavirus 2019 pandemic caused major challenges for health supply chain systems in Uganda and globally. Objectives This study involved literature review to examine how the electronic logistics management information system and related digital systems were harnessed be best support public health emergencies. Methods We describe how the health supply chain system leveraged the emergency Electronic Logistic Management Information System developed during the Ebola epidemic in 2019 to support the COVID-19 response in Uganda. The findings are based on the analysis of reports, guidelines, and discussions with stakeholders involved in implementing the electronic Management Information System during the COVID-19 response. Lessons and experiences are shared on how the system supported data visibility, use and health commodity management. Res...

BMC, Journal of Pharmaceutical Policy and Practice , 2023

Background Health supply chain is crucial for proper functioning of a health system and advancing... more Background Health supply chain is crucial for proper functioning of a health system and advancing national and international health security goals. The Coronavirus 2019 pandemic caused major challenges for health supply chain systems in Uganda and globally. Objectives This study involved literature review to examine how the electronic logistics management information system and related digital systems were harnessed be best support public health emergencies.

Global Health Supply Chain Systems have been unprecedentedly strained to the limits following the... more Global Health Supply Chain Systems have been unprecedentedly strained to the limits following the coronavirus disease 2019 (COVID-19) pandemic outbreak, raising a concern of the possible magnitude of impact likely to be posed on health supply chain systems of low-income countries like Uganda. Uganda experienced its first COVID-19 outbreak on 21 st March 2020, 10 days shortly after World Health Organization's (WHO) pandemic declaration. Ever since then, the number of cases in Uganda has gone on to rise every day. This paper aims to examine in detail the experiences and effectiveness of Uganda's health supply chain system in preparedness and response to COVID-19 outbreak. All components of Uganda's public health emergency (PHE) supply chain system and activities undertaken were examined. Ministry of Health (MoH) reports, Logistic Subcommittee (LSC) reports and published journals on COVID-19 were used to inform this paper. Upon declaration of the novel coronavirus (SARS-CoV-2) outbreak a Public Health Emergency of International Concern by WHO on 30 th January 2020, MoH activated the Public Health Emergency Operations Center, National Task Force and District Task Forces to coordinate the COVID-19 preparedness and response. On 31 st January 2020 the LSC activated the PHE supply chain system components and activities. The National Medical Countermeasures plan was activated. Quantification, forecasting and pipeline monitoring for possible logistics needs of COVID-19 was conducted for 136 districts, 8 regional prepositioning centers, 17Regional referral hospitals, over 80 public hospitals, 89 quarantine centers, and 75points of entry. The electronic Emergency Logistics Management Information system (eELMIS) was activated to coordinate all emergency supply chain information and regular reporting of stock status at all levels. Eight (8) regional prepositioning centers for stockpiling COVID-19 supplies were activated. In conclusion, the COVID-19 epidemic outbreak provided a stun on-field test for Uganda's young PHE supply chain system giving it an opportunity to close all the gaps not earlier well-known, and consequently making it even stronger for future epidemics. This paper therefore shares Uganda's experiences, methods and performance and future lessons from which other countries' health supply chain systems can learn from.

After registering its first Coronavirus disease 2019 (COVID-19) case on 21st March 2020, Uganda’s... more After registering its first Coronavirus disease 2019 (COVID-19) case on 21st March 2020, Uganda’s Ministry of Health (MoH) declared the COVID-19 pandemic outbreak in Uganda, triggering activation of the Public Health Emergency (PHE) supply chain system. At the center of Uganda’s PHE supply chain system lies a robust electronic information system known as the electronic Emergency Logistics Management Information System (eELMIS). This paper describes in detail the role of the eELMIS as a tool of supply chain management during Uganda’s COVID-19 emergency response. All the key functionalities and activities supported by the eELMIS were examined. Through the eELMIS, movement of COVID-19 Medical countermeasures (MCMs) was tracked for 16 Regional referral hospitals (RRHs), 8 regional prepositioning centers, 28 high risk districts, more than 80 public hospitals, 71 quarantine centers, and 54 points of entry (PoE). A total of 254 orders for COVID-19 MCMs were processed and fully issued throu...

Abstract: This study aimed at assessing risks affecting Health supply chains in Uganda using a ca... more Abstract: This study aimed at assessing risks affecting Health supply chains in Uganda using a case of Uganda Health Supply Chain project. The theoretical framework onto which this study was anchored was the normative decision theory of risk management. A cross-sectional study design was adopted employing the quantitative research approach. A sample population of 196 was used and primary data was collected using self-administered questionnaires and analyzed using STATA statistical program. Descriptive data was presented in form of graphs and frequency distribution tables. It was later analyzed and interpreted using percentages, frequencies, means, and standard deviations. The study results revealed that the greatest health supply chain risks faced by health supply chain programs in Uganda were; Financial-related risks such as cost overruns; and End user-related risks such as poor quality health commodities, poor feedback mechanisms and loss of patient lives . Other major risks disco...

International Journal of Science and Research (IJSR), 2016

This study aimed at assessing the effect of risk management on performance of Health supply chain... more This study aimed at assessing the effect of risk management on performance of Health supply chain projects in Uganda using a case of Uganda Health Supply Chain project. The specific objectives were; to determine the effect of risk identification on the performance of health supply chain projects in Uganda; assess the effect of risk analysis on the performance of health supply chain projects in Uganda; investigate the extent to which planning for risk management affects the performance of health supply chain projects in Uganda and lastly determine the extent to which risk response and control affect performance of health supply chain projects in Uganda. The study was based on the normative decision theory of risk management and the positivism research philosophy. It employed a cross-sectional study design and adopted both quantitative and qualitative approaches. A total sample population of 196 was used. Primary data was collected using self-administered questionnaires for quantitati...

Background: Highly Active Antiretroviral Therapy is efficacious in suppression of Human Immunodef... more Background: Highly Active Antiretroviral Therapy is efficacious in suppression of Human Immunodeficiency Virus (HIV) however, it is associated with numerous toxicities hence great effort has been put into development of antiretrovirals with better tolerability. The World Health Organization recommended dolutegravir as first-line antiretroviral therapy however, recent studies have raised concerns regarding its safety in real-clinical settings due to adverse drug reactions (ADEs). Hence the purpose of this study was to establish the prevalence and factors associated with adverse drug events among patients on dolutegravir-based regimen at the Immune Suppression Syndrome (ISS) Clinic- Mbarara Regional Referral Hospital (MRRH).Methods: A retrospective cross-sectional study was conducted at ISS Clinic-MRRH among 375 randomly selected patients who had been exposed to DTG-based regimen for at least 12 weeks. The patients were interviewed to obtain data on sociodemographics, dietary habits a...

BMC, AIDS Research and Therapy Journal, 2022

Background: In low income countries such as Uganda progress has been made towards achieving the U... more Background: In low income countries such as Uganda progress has been made towards achieving the United Nations AIDS programme 95-95-95 target however efforts are still impeded by pretreatment drug resistance and adverse drug events (ADEs) hence introduction of dolutegravir-based antiretroviral therapy as first-line treatment due to a higher genetic barrier to resistance, better tolerability and safety profile. However, recent studies have raised concerns regarding its safety in real-clinical settings due to ADEs and being a recently introduced drug there is need to actively monitor for ADEs, hence this study aimed to establish the prevalence and factors associated with ADEs among patients on dolutegravir-based regimen at the Immune Suppression Syndrome (ISS) Clinic-Mbarara Regional Referral Hospital (MRRH). Methods: A mixed design study was conducted at ISS Clinic-MRRH among 375 randomly selected patients who had been exposed to DTG-based regimen for at-least 12 weeks. These were interviewed to obtain data on sociodemographics, dietary habits and their files reviewed for ADEs. Data entry was done using Epi-data 3.0 and exported to SPSS 25.0 for analysis. Prevalence was determined as a percentage, and ADE associated factors assessed using bivariate analysis, those found significant were further subjected to multivariate analysis and considered significant at P < 0.05. Results: The prevalence of ADEs among patients on DTG-based regimen was found to be 33.1% (124/375) with 5.6% (7/124) participants discontinued from treatment due ADEs, 4 due to hyperglycemia and 3 liver toxicity. The commonly experienced ADE was allergy at 36.3%. Male sex (AOR 1.571, 95% CI 1.433-1.984), WHO stage one at entry to care (AOR 4.586, 95% CI 1.649-12.754), stage two (AOR 4.536, 95% CI 1.611-12.776), stage three (AOR 3.638, 95% CI 1.262-10.488), were significantly associated with ADEs. Patients with undetectable viral load at initiation of DTG-based regimen were 67.6% less likely to experience ADEs (AOR = 0.324, 95% CI 0.1167-0.629).

International Journal of Science and Research, 2020

Global Health Supply Chain Systems have been unprecedentedly strained to the limits following the... more Global Health Supply Chain Systems have been unprecedentedly strained to the limits following the coronavirus disease 2019 (COVID-19) pandemic outbreak, raising a concern of the possible magnitude of impact likely to be posed on health supply chain systems of low-income countries like Uganda. Uganda experienced its first COVID-19 outbreak on 21 st March 2020, 10 days shortly after World Health Organization's (WHO) pandemic declaration. Ever since then, the number of cases in Uganda has gone on to rise every day. This paper aims to examine in detail the experiences and effectiveness of Uganda's health supply chain system in preparedness and response to COVID-19 outbreak. All components of Uganda's public health emergency (PHE) supply chain system and activities undertaken were examined. Ministry of Health (MoH) reports, Logistic Subcommittee (LSC) reports and published journals on COVID-19 were used to inform this paper. Upon declaration of the novel coronavirus (SARS-CoV-2) outbreak a Public Health Emergency of International Concern by WHO on 30 th January 2020, MoH activated the Public Health Emergency Operations Center, National Task Force and District Task Forces to coordinate the COVID-19 preparedness and response. On 31 st January 2020 the LSC activated the PHE supply chain system components and activities. The National Medical Countermeasures plan was activated. Quantification, forecasting and pipeline monitoring for possible logistics needs of COVID-19 was conducted for 136 districts, 8 regional prepositioning centers, 17Regional referral hospitals, over 80 public hospitals, 89 quarantine centers, and 75points of entry. The electronic Emergency Logistics Management Information system (eELMIS) was activated to coordinate all emergency supply chain information and regular reporting of stock status at all levels. Eight (8) regional prepositioning centers for stockpiling COVID-19 supplies were activated. In conclusion, the COVID-19 epidemic outbreak provided a stun on-field test for Uganda's young PHE supply chain system giving it an opportunity to close all the gaps not earlier well-known, and consequently making it even stronger for future epidemics. This paper therefore shares Uganda's experiences, methods and performance and future lessons from which other countries' health supply chain systems can learn from.

International Journal of Science and Research, 2020

After registering its first Coronavirus disease 2019 (COVID-19) case on 21st March 2020, Uganda's... more After registering its first Coronavirus disease 2019 (COVID-19) case on 21st March 2020, Uganda's Ministry of Health (MoH) declared the COVID-19 pandemic outbreak in Uganda, triggering activation of the Public Health Emergency (PHE) supply chain system. At the center of Uganda's PHE supply chain system lies a robust electronic information system known as the electronic Emergency Logistics Management Information System (eELMIS). This paper describes in detail the role of the eELMIS as a tool of supply chain management during Uganda's COVID-19 emergency response. All the key functionalities and activities supported by the eELMIS were examined. Through the eELMIS, movement of COVID-19 Medical countermeasures (MCMs) was tracked for 16 Regional referral hospitals (RRHs), 8 regional prepositioning centers, 28 high risk districts, more than 80 public hospitals, 71 quarantine centers, and 54 points of entry (PoE). A total of 254 orders for COVID-19 MCMs were processed and fully issued through the eELMIS to ensure constant availability of MCMs at frontlines. Quantification, forecasting and pipeline monitoring for the entire country was successfully conducted through the eELMIS. Real time data visibility of COVID-19 supplies at treatment centers, district stores, regional prepositioning centers, central warehouses and partner stores was ensured. The eELMIS further provided routine reports to the Logistic subcommittee (LSC) on the country's emergency stock-status, stock gap analysis, and national aggregate stock to support top management decision making for the country. In conclusion, the eELMIS formed the backbone of a seamless COVID-19 supply chain emergency response for Uganda, linking the national level, sub-national levels, and health facilities and hence improving response time. This paper therefore shares Uganda's experiences in using the eELMIS as a tool of supply chain management during Uganda's COVID-19 pandemic response from which other countries without established emergency electronic logistic information systems to support their existing health supply chain systems can learn from.

International Journal of Science and Research, 2020

This study aimed at assessing the effect of risk management on performance of Health supply chain... more This study aimed at assessing the effect of risk management on performance of Health supply chain projects in Uganda using a case of Uganda Health Supply Chain project. The specific objectives were; to determine the effect of risk identification on the performance of health supply chain projects in Uganda; assess the effect of risk analysis on the performance of health supply chain projects in Uganda; investigate the extent to which planning for risk management affects the performance of health supply chain projects in Uganda and lastly determine the extent to which risk response and control affect performance of health supply chain projects in Uganda. The study was based on the normative decision theory of risk management and the positivism research philosophy. It employed a cross-sectional study design and adopted both quantitative and qualitative approaches. A total sample population of 196 was used. Primary data was collected using self-administered questionnaires for quantitative data and analyzed using STATA while qualitative data was collected using an interview guide and analyzed using the content analysis method. In this study, four hypotheses
were tested using the logistic regression technique employing the p-value and odds ratio approach. Findings revealed a good understanding of the risk management concept among a majority of the respondents, but however, there was a low adoption of standard risk management practices. The study further revealed that a majority of the investigated practices had a significant effect on the level of time, cost and quality performance of health supply chain projects in Uganda. The study concluded that performance of health supply chain projects in Uganda has been below average due to low adoption of standard risk management practices. The study recommended prioritizing risk management high on the project’s management agenda by all supply chain projects in Uganda.

International Journal of Science and Research, 2020

This study aimed at assessing risks affecting Health supply chains in Uganda using a case of Ugan... more This study aimed at assessing risks affecting Health supply chains in Uganda using a case of Uganda Health Supply Chain project. The theoretical framework onto which this study was anchored was the normative decision theory of risk management. A cross-sectional study design was adopted employing the quantitative research approach. A sample population of 196 was used and primary data was collected using self-administered questionnaires and analyzed using STATA statistical program. Descriptive data was presented in form of graphs and frequency distribution tables. It was later analyzed and interpreted using percentages, frequencies, means, and standard deviations. The study results revealed that the greatest health supply chain risks faced by health supply chain programs in Uganda were; Financial-related risks such as cost overruns; and End user-related risks such as poor quality health commodities, poor feedback mechanisms and loss of patient lives. Other major risks discovered by the study included demand and supply-related risks resulting from supplier unpredictability such as stock outs; Procurement-related risks such as long lead-times and inadequate technical input; and distribution and Storage-related risks. Environmental-related risks such as accidents, bad weather and political instability
were the least faced risks. The study concluded that health supply chains in Uganda are troubled by a multitude of risks, and therefore the study recommended that,after a clear understanding of risks affecting health supply chains has been uncovered, carefully-tailored standard risk management processes can be established within health supply chain projects to improve the functionality of Uganda’s health supply chain management systems.

International Journal of Science and Research, 2016

This study aimed at evaluating the POV care model and its effects on the quality of care of HIV p... more This study aimed at evaluating the POV care model and its effects on the quality of care of HIV patients in Mulago HIV clinic. Its specific objectives were to; determine the effect of the pharmacy only visit care model on the level of patient satisfaction in Mulago HIV clinic; assess the effects of the pharmacy only visit care model on Adherence of patients; and assess the benefits of the pharmacy only visit care model to patients on this model in Mulago HIV clinic. Overall the clients were satisfied with the POV model and the level of patients’ adherence to treatment has greatly improved. The Model has also benefited the clients in terms of time, cost saved in seeking care. Increased autonomy, confidence, self management, and trust from doctors have been realized by the clients under the POV.

International Health Sciences University, 2013

Using highly active antiretroviral therapy (HAART) as the core preference for management of peopl... more Using highly active antiretroviral therapy (HAART) as the core preference for management of people infected with Human Immune deficiency virus (HIV) is associated with decreased mortality and morbidity. However with HAART there come a considerable number of adverse drug reactions which are not monitored and reported in many settings. ADR reporting is a critical tool in pharmacovigilance. Its success however, depends on collaborative and motivated healthcare providers. Under reporting of adverse drug reactions (ADRs) by healthcare providers is a prevalent or common problem. The current study was undertaken to assess the pharmacovigilance among ART healthcare providers in Mulago HIV clinic through evaluating the common ADRs and their causes, then assessing their monitoring and reporting by evaluating the knowledge, attitude, and practices (KAP) regarding ADR reporting among healthcare providers at Mulago HIV clinic, to get an insight into the causes of under reporting of ADRs.

Keywords: eELMIS, Public health emergency, Health supply chain system, information system, COVID-... more Keywords: eELMIS, Public health emergency, Health supply chain system, information system, COVID-19emergency preparedness and response, Uganda Through the eELMIS health facilities and partners at the national, regional, district, and facility levels can enter their emergency stock requests into the system.

Conference Presentations by John Hans Wasswa

IAS COVID-19 Conference: Prevention, 2021

BACKGROUND: The Coronavirus 2019 pandemic remains the greatest public health challenge globally a... more BACKGROUND: The Coronavirus 2019 pandemic remains the greatest public health challenge globally and in Uganda. This challenge emerged in Uganda when the supply chain system was not positioned to handle the COVID 19 pandemic. The health system faces several challenges notably an increase in the demand for emergency supplies.
DESCRIPTION: We describe how leveraging the electronic Emergency Logistic Management Information System during the Ebola epidemic in early 2019 supported the supply chain system during the COVID-19 response. Lessons and experiences are shared on how the system supported data visibility and use. This article is based on the analysis of reports, guidelines, and discussions with stakeholders involved in implementing the electronic Management Information System during the COVID-19 response.
LESSONS LEARNED: The web based electronic Management Information System was established to support the supply chain systems preparedness and response to the Ebola Virus. The system facilitated coordination, information management, distribution of commodities and provided real time data for planning and decision making during in the COVID-19 response. To address any capacity challenges, 786 staff were trained in the use of the system. The system enabled the Ministry of Health to track movement of Medical Counter Measures through the warehouses, eight regional pre-positioning centers, and over 2,000 user units in 136 district stores. Additionally, the system provided quality data for the quantification and monitoring of commodities at all levels of care. Over 500 bulk orders for supplies were made, served through the system. Real time reports on stock status at the central, regional, district and health facility levels were generated. Procurement tracking reports, stock gap analysis and partner contribution were all accessible and visible in the system. This supported the Ministry of Health's resource mobilization and coordination efforts.
CONCLUSIONS: The availability of reliable, quality real-time data is important for effective decision making during public health emergencies. The eLMIS supported health authorities to mount coordinated and effective responses to ensure the timely availability of emergency medicines and supplies during the COVID-19 pandemic. Lessons from the Ebola epidemic translated into actions that enabled effective response to the COVID-19 pandemic.

Journal of Pharmaceutical Policy and Practice

Background Health supply chain is crucial for proper functioning of a health system and advancing... more Background Health supply chain is crucial for proper functioning of a health system and advancing national and international health security goals. The Coronavirus 2019 pandemic caused major challenges for health supply chain systems in Uganda and globally. Objectives This study involved literature review to examine how the electronic logistics management information system and related digital systems were harnessed be best support public health emergencies. Methods We describe how the health supply chain system leveraged the emergency Electronic Logistic Management Information System developed during the Ebola epidemic in 2019 to support the COVID-19 response in Uganda. The findings are based on the analysis of reports, guidelines, and discussions with stakeholders involved in implementing the electronic Management Information System during the COVID-19 response. Lessons and experiences are shared on how the system supported data visibility, use and health commodity management. Res...

BMC, Journal of Pharmaceutical Policy and Practice , 2023

Background Health supply chain is crucial for proper functioning of a health system and advancing... more Background Health supply chain is crucial for proper functioning of a health system and advancing national and international health security goals. The Coronavirus 2019 pandemic caused major challenges for health supply chain systems in Uganda and globally. Objectives This study involved literature review to examine how the electronic logistics management information system and related digital systems were harnessed be best support public health emergencies.

Global Health Supply Chain Systems have been unprecedentedly strained to the limits following the... more Global Health Supply Chain Systems have been unprecedentedly strained to the limits following the coronavirus disease 2019 (COVID-19) pandemic outbreak, raising a concern of the possible magnitude of impact likely to be posed on health supply chain systems of low-income countries like Uganda. Uganda experienced its first COVID-19 outbreak on 21 st March 2020, 10 days shortly after World Health Organization's (WHO) pandemic declaration. Ever since then, the number of cases in Uganda has gone on to rise every day. This paper aims to examine in detail the experiences and effectiveness of Uganda's health supply chain system in preparedness and response to COVID-19 outbreak. All components of Uganda's public health emergency (PHE) supply chain system and activities undertaken were examined. Ministry of Health (MoH) reports, Logistic Subcommittee (LSC) reports and published journals on COVID-19 were used to inform this paper. Upon declaration of the novel coronavirus (SARS-CoV-2) outbreak a Public Health Emergency of International Concern by WHO on 30 th January 2020, MoH activated the Public Health Emergency Operations Center, National Task Force and District Task Forces to coordinate the COVID-19 preparedness and response. On 31 st January 2020 the LSC activated the PHE supply chain system components and activities. The National Medical Countermeasures plan was activated. Quantification, forecasting and pipeline monitoring for possible logistics needs of COVID-19 was conducted for 136 districts, 8 regional prepositioning centers, 17Regional referral hospitals, over 80 public hospitals, 89 quarantine centers, and 75points of entry. The electronic Emergency Logistics Management Information system (eELMIS) was activated to coordinate all emergency supply chain information and regular reporting of stock status at all levels. Eight (8) regional prepositioning centers for stockpiling COVID-19 supplies were activated. In conclusion, the COVID-19 epidemic outbreak provided a stun on-field test for Uganda's young PHE supply chain system giving it an opportunity to close all the gaps not earlier well-known, and consequently making it even stronger for future epidemics. This paper therefore shares Uganda's experiences, methods and performance and future lessons from which other countries' health supply chain systems can learn from.

After registering its first Coronavirus disease 2019 (COVID-19) case on 21st March 2020, Uganda’s... more After registering its first Coronavirus disease 2019 (COVID-19) case on 21st March 2020, Uganda’s Ministry of Health (MoH) declared the COVID-19 pandemic outbreak in Uganda, triggering activation of the Public Health Emergency (PHE) supply chain system. At the center of Uganda’s PHE supply chain system lies a robust electronic information system known as the electronic Emergency Logistics Management Information System (eELMIS). This paper describes in detail the role of the eELMIS as a tool of supply chain management during Uganda’s COVID-19 emergency response. All the key functionalities and activities supported by the eELMIS were examined. Through the eELMIS, movement of COVID-19 Medical countermeasures (MCMs) was tracked for 16 Regional referral hospitals (RRHs), 8 regional prepositioning centers, 28 high risk districts, more than 80 public hospitals, 71 quarantine centers, and 54 points of entry (PoE). A total of 254 orders for COVID-19 MCMs were processed and fully issued throu...

Abstract: This study aimed at assessing risks affecting Health supply chains in Uganda using a ca... more Abstract: This study aimed at assessing risks affecting Health supply chains in Uganda using a case of Uganda Health Supply Chain project. The theoretical framework onto which this study was anchored was the normative decision theory of risk management. A cross-sectional study design was adopted employing the quantitative research approach. A sample population of 196 was used and primary data was collected using self-administered questionnaires and analyzed using STATA statistical program. Descriptive data was presented in form of graphs and frequency distribution tables. It was later analyzed and interpreted using percentages, frequencies, means, and standard deviations. The study results revealed that the greatest health supply chain risks faced by health supply chain programs in Uganda were; Financial-related risks such as cost overruns; and End user-related risks such as poor quality health commodities, poor feedback mechanisms and loss of patient lives . Other major risks disco...

International Journal of Science and Research (IJSR), 2016

This study aimed at assessing the effect of risk management on performance of Health supply chain... more This study aimed at assessing the effect of risk management on performance of Health supply chain projects in Uganda using a case of Uganda Health Supply Chain project. The specific objectives were; to determine the effect of risk identification on the performance of health supply chain projects in Uganda; assess the effect of risk analysis on the performance of health supply chain projects in Uganda; investigate the extent to which planning for risk management affects the performance of health supply chain projects in Uganda and lastly determine the extent to which risk response and control affect performance of health supply chain projects in Uganda. The study was based on the normative decision theory of risk management and the positivism research philosophy. It employed a cross-sectional study design and adopted both quantitative and qualitative approaches. A total sample population of 196 was used. Primary data was collected using self-administered questionnaires for quantitati...

Background: Highly Active Antiretroviral Therapy is efficacious in suppression of Human Immunodef... more Background: Highly Active Antiretroviral Therapy is efficacious in suppression of Human Immunodeficiency Virus (HIV) however, it is associated with numerous toxicities hence great effort has been put into development of antiretrovirals with better tolerability. The World Health Organization recommended dolutegravir as first-line antiretroviral therapy however, recent studies have raised concerns regarding its safety in real-clinical settings due to adverse drug reactions (ADEs). Hence the purpose of this study was to establish the prevalence and factors associated with adverse drug events among patients on dolutegravir-based regimen at the Immune Suppression Syndrome (ISS) Clinic- Mbarara Regional Referral Hospital (MRRH).Methods: A retrospective cross-sectional study was conducted at ISS Clinic-MRRH among 375 randomly selected patients who had been exposed to DTG-based regimen for at least 12 weeks. The patients were interviewed to obtain data on sociodemographics, dietary habits a...

BMC, AIDS Research and Therapy Journal, 2022

Background: In low income countries such as Uganda progress has been made towards achieving the U... more Background: In low income countries such as Uganda progress has been made towards achieving the United Nations AIDS programme 95-95-95 target however efforts are still impeded by pretreatment drug resistance and adverse drug events (ADEs) hence introduction of dolutegravir-based antiretroviral therapy as first-line treatment due to a higher genetic barrier to resistance, better tolerability and safety profile. However, recent studies have raised concerns regarding its safety in real-clinical settings due to ADEs and being a recently introduced drug there is need to actively monitor for ADEs, hence this study aimed to establish the prevalence and factors associated with ADEs among patients on dolutegravir-based regimen at the Immune Suppression Syndrome (ISS) Clinic-Mbarara Regional Referral Hospital (MRRH). Methods: A mixed design study was conducted at ISS Clinic-MRRH among 375 randomly selected patients who had been exposed to DTG-based regimen for at-least 12 weeks. These were interviewed to obtain data on sociodemographics, dietary habits and their files reviewed for ADEs. Data entry was done using Epi-data 3.0 and exported to SPSS 25.0 for analysis. Prevalence was determined as a percentage, and ADE associated factors assessed using bivariate analysis, those found significant were further subjected to multivariate analysis and considered significant at P < 0.05. Results: The prevalence of ADEs among patients on DTG-based regimen was found to be 33.1% (124/375) with 5.6% (7/124) participants discontinued from treatment due ADEs, 4 due to hyperglycemia and 3 liver toxicity. The commonly experienced ADE was allergy at 36.3%. Male sex (AOR 1.571, 95% CI 1.433-1.984), WHO stage one at entry to care (AOR 4.586, 95% CI 1.649-12.754), stage two (AOR 4.536, 95% CI 1.611-12.776), stage three (AOR 3.638, 95% CI 1.262-10.488), were significantly associated with ADEs. Patients with undetectable viral load at initiation of DTG-based regimen were 67.6% less likely to experience ADEs (AOR = 0.324, 95% CI 0.1167-0.629).

International Journal of Science and Research, 2020

Global Health Supply Chain Systems have been unprecedentedly strained to the limits following the... more Global Health Supply Chain Systems have been unprecedentedly strained to the limits following the coronavirus disease 2019 (COVID-19) pandemic outbreak, raising a concern of the possible magnitude of impact likely to be posed on health supply chain systems of low-income countries like Uganda. Uganda experienced its first COVID-19 outbreak on 21 st March 2020, 10 days shortly after World Health Organization's (WHO) pandemic declaration. Ever since then, the number of cases in Uganda has gone on to rise every day. This paper aims to examine in detail the experiences and effectiveness of Uganda's health supply chain system in preparedness and response to COVID-19 outbreak. All components of Uganda's public health emergency (PHE) supply chain system and activities undertaken were examined. Ministry of Health (MoH) reports, Logistic Subcommittee (LSC) reports and published journals on COVID-19 were used to inform this paper. Upon declaration of the novel coronavirus (SARS-CoV-2) outbreak a Public Health Emergency of International Concern by WHO on 30 th January 2020, MoH activated the Public Health Emergency Operations Center, National Task Force and District Task Forces to coordinate the COVID-19 preparedness and response. On 31 st January 2020 the LSC activated the PHE supply chain system components and activities. The National Medical Countermeasures plan was activated. Quantification, forecasting and pipeline monitoring for possible logistics needs of COVID-19 was conducted for 136 districts, 8 regional prepositioning centers, 17Regional referral hospitals, over 80 public hospitals, 89 quarantine centers, and 75points of entry. The electronic Emergency Logistics Management Information system (eELMIS) was activated to coordinate all emergency supply chain information and regular reporting of stock status at all levels. Eight (8) regional prepositioning centers for stockpiling COVID-19 supplies were activated. In conclusion, the COVID-19 epidemic outbreak provided a stun on-field test for Uganda's young PHE supply chain system giving it an opportunity to close all the gaps not earlier well-known, and consequently making it even stronger for future epidemics. This paper therefore shares Uganda's experiences, methods and performance and future lessons from which other countries' health supply chain systems can learn from.

International Journal of Science and Research, 2020

After registering its first Coronavirus disease 2019 (COVID-19) case on 21st March 2020, Uganda's... more After registering its first Coronavirus disease 2019 (COVID-19) case on 21st March 2020, Uganda's Ministry of Health (MoH) declared the COVID-19 pandemic outbreak in Uganda, triggering activation of the Public Health Emergency (PHE) supply chain system. At the center of Uganda's PHE supply chain system lies a robust electronic information system known as the electronic Emergency Logistics Management Information System (eELMIS). This paper describes in detail the role of the eELMIS as a tool of supply chain management during Uganda's COVID-19 emergency response. All the key functionalities and activities supported by the eELMIS were examined. Through the eELMIS, movement of COVID-19 Medical countermeasures (MCMs) was tracked for 16 Regional referral hospitals (RRHs), 8 regional prepositioning centers, 28 high risk districts, more than 80 public hospitals, 71 quarantine centers, and 54 points of entry (PoE). A total of 254 orders for COVID-19 MCMs were processed and fully issued through the eELMIS to ensure constant availability of MCMs at frontlines. Quantification, forecasting and pipeline monitoring for the entire country was successfully conducted through the eELMIS. Real time data visibility of COVID-19 supplies at treatment centers, district stores, regional prepositioning centers, central warehouses and partner stores was ensured. The eELMIS further provided routine reports to the Logistic subcommittee (LSC) on the country's emergency stock-status, stock gap analysis, and national aggregate stock to support top management decision making for the country. In conclusion, the eELMIS formed the backbone of a seamless COVID-19 supply chain emergency response for Uganda, linking the national level, sub-national levels, and health facilities and hence improving response time. This paper therefore shares Uganda's experiences in using the eELMIS as a tool of supply chain management during Uganda's COVID-19 pandemic response from which other countries without established emergency electronic logistic information systems to support their existing health supply chain systems can learn from.

International Journal of Science and Research, 2020

This study aimed at assessing the effect of risk management on performance of Health supply chain... more This study aimed at assessing the effect of risk management on performance of Health supply chain projects in Uganda using a case of Uganda Health Supply Chain project. The specific objectives were; to determine the effect of risk identification on the performance of health supply chain projects in Uganda; assess the effect of risk analysis on the performance of health supply chain projects in Uganda; investigate the extent to which planning for risk management affects the performance of health supply chain projects in Uganda and lastly determine the extent to which risk response and control affect performance of health supply chain projects in Uganda. The study was based on the normative decision theory of risk management and the positivism research philosophy. It employed a cross-sectional study design and adopted both quantitative and qualitative approaches. A total sample population of 196 was used. Primary data was collected using self-administered questionnaires for quantitative data and analyzed using STATA while qualitative data was collected using an interview guide and analyzed using the content analysis method. In this study, four hypotheses
were tested using the logistic regression technique employing the p-value and odds ratio approach. Findings revealed a good understanding of the risk management concept among a majority of the respondents, but however, there was a low adoption of standard risk management practices. The study further revealed that a majority of the investigated practices had a significant effect on the level of time, cost and quality performance of health supply chain projects in Uganda. The study concluded that performance of health supply chain projects in Uganda has been below average due to low adoption of standard risk management practices. The study recommended prioritizing risk management high on the project’s management agenda by all supply chain projects in Uganda.

International Journal of Science and Research, 2020

This study aimed at assessing risks affecting Health supply chains in Uganda using a case of Ugan... more This study aimed at assessing risks affecting Health supply chains in Uganda using a case of Uganda Health Supply Chain project. The theoretical framework onto which this study was anchored was the normative decision theory of risk management. A cross-sectional study design was adopted employing the quantitative research approach. A sample population of 196 was used and primary data was collected using self-administered questionnaires and analyzed using STATA statistical program. Descriptive data was presented in form of graphs and frequency distribution tables. It was later analyzed and interpreted using percentages, frequencies, means, and standard deviations. The study results revealed that the greatest health supply chain risks faced by health supply chain programs in Uganda were; Financial-related risks such as cost overruns; and End user-related risks such as poor quality health commodities, poor feedback mechanisms and loss of patient lives. Other major risks discovered by the study included demand and supply-related risks resulting from supplier unpredictability such as stock outs; Procurement-related risks such as long lead-times and inadequate technical input; and distribution and Storage-related risks. Environmental-related risks such as accidents, bad weather and political instability
were the least faced risks. The study concluded that health supply chains in Uganda are troubled by a multitude of risks, and therefore the study recommended that,after a clear understanding of risks affecting health supply chains has been uncovered, carefully-tailored standard risk management processes can be established within health supply chain projects to improve the functionality of Uganda’s health supply chain management systems.

International Journal of Science and Research, 2016

This study aimed at evaluating the POV care model and its effects on the quality of care of HIV p... more This study aimed at evaluating the POV care model and its effects on the quality of care of HIV patients in Mulago HIV clinic. Its specific objectives were to; determine the effect of the pharmacy only visit care model on the level of patient satisfaction in Mulago HIV clinic; assess the effects of the pharmacy only visit care model on Adherence of patients; and assess the benefits of the pharmacy only visit care model to patients on this model in Mulago HIV clinic. Overall the clients were satisfied with the POV model and the level of patients’ adherence to treatment has greatly improved. The Model has also benefited the clients in terms of time, cost saved in seeking care. Increased autonomy, confidence, self management, and trust from doctors have been realized by the clients under the POV.

International Health Sciences University, 2013

Using highly active antiretroviral therapy (HAART) as the core preference for management of peopl... more Using highly active antiretroviral therapy (HAART) as the core preference for management of people infected with Human Immune deficiency virus (HIV) is associated with decreased mortality and morbidity. However with HAART there come a considerable number of adverse drug reactions which are not monitored and reported in many settings. ADR reporting is a critical tool in pharmacovigilance. Its success however, depends on collaborative and motivated healthcare providers. Under reporting of adverse drug reactions (ADRs) by healthcare providers is a prevalent or common problem. The current study was undertaken to assess the pharmacovigilance among ART healthcare providers in Mulago HIV clinic through evaluating the common ADRs and their causes, then assessing their monitoring and reporting by evaluating the knowledge, attitude, and practices (KAP) regarding ADR reporting among healthcare providers at Mulago HIV clinic, to get an insight into the causes of under reporting of ADRs.

Keywords: eELMIS, Public health emergency, Health supply chain system, information system, COVID-... more Keywords: eELMIS, Public health emergency, Health supply chain system, information system, COVID-19emergency preparedness and response, Uganda Through the eELMIS health facilities and partners at the national, regional, district, and facility levels can enter their emergency stock requests into the system.

IAS COVID-19 Conference: Prevention, 2021

BACKGROUND: The Coronavirus 2019 pandemic remains the greatest public health challenge globally a... more BACKGROUND: The Coronavirus 2019 pandemic remains the greatest public health challenge globally and in Uganda. This challenge emerged in Uganda when the supply chain system was not positioned to handle the COVID 19 pandemic. The health system faces several challenges notably an increase in the demand for emergency supplies.
DESCRIPTION: We describe how leveraging the electronic Emergency Logistic Management Information System during the Ebola epidemic in early 2019 supported the supply chain system during the COVID-19 response. Lessons and experiences are shared on how the system supported data visibility and use. This article is based on the analysis of reports, guidelines, and discussions with stakeholders involved in implementing the electronic Management Information System during the COVID-19 response.
LESSONS LEARNED: The web based electronic Management Information System was established to support the supply chain systems preparedness and response to the Ebola Virus. The system facilitated coordination, information management, distribution of commodities and provided real time data for planning and decision making during in the COVID-19 response. To address any capacity challenges, 786 staff were trained in the use of the system. The system enabled the Ministry of Health to track movement of Medical Counter Measures through the warehouses, eight regional pre-positioning centers, and over 2,000 user units in 136 district stores. Additionally, the system provided quality data for the quantification and monitoring of commodities at all levels of care. Over 500 bulk orders for supplies were made, served through the system. Real time reports on stock status at the central, regional, district and health facility levels were generated. Procurement tracking reports, stock gap analysis and partner contribution were all accessible and visible in the system. This supported the Ministry of Health's resource mobilization and coordination efforts.
CONCLUSIONS: The availability of reliable, quality real-time data is important for effective decision making during public health emergencies. The eLMIS supported health authorities to mount coordinated and effective responses to ensure the timely availability of emergency medicines and supplies during the COVID-19 pandemic. Lessons from the Ebola epidemic translated into actions that enabled effective response to the COVID-19 pandemic.