We Need To Rethink The Safety Of Patients In Our Health Facilities

Considering the significant burden of risks and harm women and new-borns are exposed to due to unsafe care, compounded by the disruption of essential health services caused by the COVID-19 pandemic, the campaign is even more important this year. For the world safety day 17th September, 2021, we call on government and other stakeholders to act now for safe and respectful child birth under the theme “Safe Maternal and new born care.”

By peter eceru

The media has in the recent past reported cases of abuse of patients, health workers and other health users in health facilities. These included cases of sexual abuse of health workers, patients and care givers with in the health facilities. Relatedly, there have been cases of health workers and non-health workers administering medication with disastrous consequences to the patients. It is against this background that the WHO declared September 17th a world patient safety day to raise global awareness about patient safety and call for solidarity and united action by all to reduce harm. Safety plays an important role in the daily operation of any health care facility. Safety means that there is absence of preventable harm to a patient during the process of receiving health care. Effective safety management not only assures employees that they have a safe working environment, but also allows patients to enjoy an atmosphere that is free from unnecessary risks and hazards. Having an effective safety program that addresses pertinent safety issues within the facility, as well as within the community will give the administration confidence that the facility is delivering the highest quality of patient care.

While Uganda committed to achieving Universal Health Coverage, safety which is one of the key pillars continues to be hugely ignored. Patients and other service users will be more comfortable when they are assured of safety when they go to a health facility be it private or public. Safety encompasses the need, use and quality of interventions provided by the health system.

Out of the realization and concern for the safety of patients, the Ministry of Health put in place a Patient Rights and Responsibilities Charter 2009 – an official document that offers guidance on various patient rights and responsibilities in the national health care system. Prominent in the document is the notion of human dignity and the provision of moral ground towards improving standard health services in the country. While the country has an elaborate legislation in relation to safety of patients, the challenge for the country relates largely to the implementation and how health facility administrators construe safety. In most health facilities, Health Facility safety committees have not been established. The law requires that each health facility should have in place a safety committee which is supposed to oversee safety issues and make recommendations on how to better safety in health facilities. Most health facilities have confused this with the Infectious Disease Control committee which have been active because COVID.

The COVID pandemic has demonstrated that the safety of patients is closely related to the safety of health workers. It has also reminded all of us of the vital role health workers play to relieve suffering and save lives. In addition to physical risks, the pandemic has placed extraordinary levels of psychological stress on health workers exposed to high-demand settings for long hours, living in constant fear of disease exposure while separated from family and facing social stigmatisation. The World Health Organisation recently highlighted an alarming rise in reports of verbal harassment, discrimination, and physical violence against health workers in the wake of COVID-19. No country, hospital or clinic can keep its mothers and children safe without keeping its workers safe.

It is important to remind the government that it has a legal and moral obligation to ensure the health, safety and wellbeing of health facility workers, health facility users and make seeking health services a dignified process.  To do this government needs to take deliberate actions to ensure availability of personal protective equipment (PPE) at all times, as relevant to the roles and tasks performed, in adequate quantity and appropriate fit and of acceptable quality. There should also be adequate, locally held, buffer stock of PPE. Ensure adequate training on the appropriate use of PPE and safety precautions., maintaining appropriate safe staffing levels within health facilities, provide assurance of provision of free health coverage for health workers for work related risks, especially for those working in high-risk areas.

The media has in the recent past reported cases of abuse of patients, health workers and other health users in health facilities. These included cases of sexual abuse of health workers, patients and care givers with in the health facilities. Relatedly, there have been cases of health workers and non-health workers administering medication with disastrous consequences to the patients. It is against this background that the WHO declared September 17th a world patient safety day to raise global awareness about patient safety and call for solidarity and united action by all to reduce harm. Safety plays an important role in the daily operation of any health care facility. Safety means that there is absence of preventable harm to a patient during the process of receiving health care. Effective safety management not only assures employees that they have a safe working environment, but also allows patients to enjoy an atmosphere that is free from unnecessary risks and hazards. Having an effective safety program that addresses pertinent safety issues within the facility, as well as within the community will give the administration confidence that the facility is delivering the highest quality of patient care.

While Uganda committed to achieving Universal Health Coverage, safety which is one of the key pillars continues to be hugely ignored. Patients and other service users will be more comfortable when they are assured of safety when they go to a health facility be it private or public. Safety encompasses the need, use and quality of interventions provided by the health system.

Out of the realization and concern for the safety of patients, the Ministry of Health put in place a Patient Rights and Responsibilities Charter 2009 – an official document that offers guidance on various patient rights and responsibilities in the national health care system. Prominent in the document is the notion of human dignity and the provision of moral ground towards improving standard health services in the country. While the country has an elaborate legislation in relation to safety of patients, the challenge for the country relates largely to the implementation and how health facility administrators construe safety. In most health facilities, Health Facility safety committees have not been established. The law requires that each health facility should have in place a safety committee which is supposed to oversee safety issues and make recommendations on how to better safety in health facilities. Most health facilities have confused this with the Infectious Disease Control committee which have been active because COVID.

The COVID pandemic has demonstrated that the safety of patients is closely related to the safety of health workers. It has also reminded all of us of the vital role health workers play to relieve suffering and save lives. In addition to physical risks, the pandemic has placed extraordinary levels of psychological stress on health workers exposed to high-demand settings for long hours, living in constant fear of disease exposure while separated from family and facing social stigmatisation. The World Health Organisation recently highlighted an alarming rise in reports of verbal harassment, discrimination, and physical violence against health workers in the wake of COVID-19. No country, hospital or clinic can keep its mothers and children safe without keeping its workers safe.

It is important to remind the government that it has a legal and moral obligation to ensure the health, safety and wellbeing of health facility workers, health facility users and make seeking health services a dignified process.  To do this government needs to take deliberate actions to ensure availability of personal protective equipment (PPE) at all times, as relevant to the roles and tasks performed, in adequate quantity and appropriate fit and of acceptable quality. There should also be adequate, locally held, buffer stock of PPE. Ensure adequate training on the appropriate use of PPE and safety precautions., maintaining appropriate safe staffing levels within health facilities, provide assurance of provision of free health coverage for health workers for work related risks, especially for those working in high-risk areas.

Considering the significant burden of risks and harm women and new-borns are exposed to due to unsafe care, compounded by the disruption of essential health services caused by the COVID-19 pandemic, the campaign is even more important this year. For the world safety day 17th September, 2021, we call on government and other stakeholders to act now for safe and respectful child birth under the theme “Safe Maternal and new born care.”

The writer is an Advocacy Expert at the Center for Health, Human Rights and Development.

Call For Expression Of Interest For a Short-Term Consultancy Service To Conduct a Mapping And Capacity Assessment For Civil Society Organisations On Governance And Accountability In Koboko And Maracha Districts

The Youth Transforming Food Systems in the Face of Covid-19

Rumors of the third wave are spreading fast and experts are cognizant of the fact that covid-19 is going to be with us for the long haul and adaptability is very key. One of the ways we can live with it is by preparing our bodies for battle. Wearing the armour of healthy eating i.e making healthy food choices for consumption.

By Miriam Kyomugisha

In the face of the second wave of Covid-19 that recently ravished our country, many youths succumbed to the deadly disease, a very sad turn of events. Following this tragic period, and in relation to this year’s International Youth Day 2021 theme “Transforming Food Systems: Youth Innovation for Human and Planetary Health’’, it is evident that some of our food choices as youths directly affects our health. Research shows and proves that when one contracts the virus, the state in which it finds their body contributes a big percentage to how one reacts to it. For instance, a person who consumes healthy foods like vegetables and fruits is most likely to beat the disease. It is public knowledge that a healthy lifestyle in especially feeding, boosts one’s immune system and equips the body with the ability to fight off the virus, viral infections are self-limiting which basically means that the body has to fight the infection on its own.

During the 2021 ECOSOC Youth Forum (EYF), the issues and priorities highlighted by young participants included the impact of the COVID-19 pandemic, particularly related to its effect on human health, the environment, and food systems. As part of the official outcome recommendations of the EYF, young participants stressed the importance of working towards more equitable food systems. In addition, they highlighted the need for youth to make informed decisions on food choices through increasing global education on the healthiest and most sustainable options for both individuals and the environment.

The food system is a complex web of activities involving the production, processing, transport and consumption. Issues concerning the food system include the governance and economics of food production, its sustainability, the degree to which we waste food, how food production affects the natural environment and the impact of food on individual and population health.

Following the aftermath of many youths dying from the COVID-19, it was discovered many of them had underlying conditions such as obesity, diabetes, cardiovascular disease and some forms of cancer. It is now common knowledge that with underlying conditions, chances of beating the disease are minimal. It is of no wonder that youths were affected most by the virus this time around, because of their preference for junk food. It would be of great significance if youths engaged more in agriculture for more production of essential foods in amounts that can ably sustain the masses.

Rumors of the third wave are spreading fast and experts are cognizant of the fact that covid-19 is going to be with us for the long haul and adaptability is very key. One of the ways we can live with it is by preparing our bodies for battle. Wearing the armour of healthy eating i.e making healthy food choices for consumption.

The high demand for healthy foods and the high rates of unemployment among the youth has brought up the question of affordability of the vital foods whose prices have been hiked. What this means is that only the well-off can afford nutritious foods. We need to get to a place where healthy food choices are made affordable to all and prioritized while deciding on what to consume as the youth.

Food systems challenges, especially nutrition-related chronic diseases such as obesity, diabetes, cardiovascular disease, and some forms of cancer are major contributors to the global burden of disease.

Celebrate the International Youth Day with us by joining conversations around the world under the hashtag #IYD2021 on Twitter, Webinars, TV and Radio conversations as we explore the role that youths can play to achieve more equitable and sustainable food systems, and highlight the fact that the success of such a global effort will not be achieved without the meaningful participation of young people.

I conclude by saying that its only when you are sick that you realise you should have eaten healthy! This is me speaking through experience as a covid survivor. ‘’Prevention is better than cure’’ has never been more accurate than in this era of COVID-19.

The writer is a program officer in the Campaigns, Partnerships and Networks programme.

How The Legal Framework Can Catalyse The Fight Against Lung Cancer In Uganda

Smoking is the leading risk factor for lung cancer. There is still a long way to go for us to start harvesting the fruits of the Tobacco Control Act, 2015. Massive sensitization still needs to be done.

Compiled by Syndia Chemutai

Since its inception in 2012, World Lung Cancer Day has been observed every August 1 with the aim of shining a light on this deadly disease and giving hope to those who are battling it. According to the latest WHO data published in 2018 Lung Cancer Deaths in Uganda reached 439 or 0.17% of total deaths and Uganda ranks at number 150 in the world. 

Smoking is the leading risk factor for lung cancer. Research from the American Cancer Society has it that about 80% of lung cancer deaths result from smoking and according to Tobacco Induced Diseases (TIB), 62.2 % of daily smokers used manufactured cigarettes. There is a high prevalence of tobacco use in Uganda with almost 1 in every 10 Ugandans using tobacco products daily. Statistics from the Uganda Cancer Institute also indicate that 25 % of lung cancer patients were tobacco users.

Globally, tobacco kills nearly 6million people worldwide including 600,000 non smokers exposed to second hand smoke. Uganda ratified the WHO Framework Convention on Tobacco Control (WHO FCTC) in 2007. The Convention was negotiated as a Global Intervention to protect present and future generations from the devastating health, environmental and socio-economic effects of tobacco. One of the steps in fighting Lung cancer besides investing in research and improving on health infrastructure to treat Lung cancer is regulating the causes and tobacco use is one of them. It is linked to 71% of lung cancer cases. 

Uganda passed the Tobacco control Act 2015 and the Tobacco Control Regulations 2019 aimed at controlling the demand for the consumption of tobacco and its products and in the long run, promote the health of persons and reduce tobacco related illnesses and deaths. The law bans smoking in all indoor places and workplaces, on all means of public transport, and in specified outdoor public places, it also bans all tobacco advertising, promotion, and sponsorship, including product displays at points of sale. It prohibits the sale of tobacco products in specified places (health institutions, schools, prisons, and other places), among others.

I commend the government upon taking the initiative as there is an impact created by the Tobacco control Act for instance non-advertisement and promotion of tobacco has been achieved. There are however instances where the provisions have not been upheld, shisha, smokeless, and flavoured tobacco are still being consumed and people can still be seen smoking on the streets and nothing is done about it. Albeit the promulgation of the laws, their enforcement and sensitization of the masses about them should be accelerated. There is no benefit of having good laws only on paper with little or no impact at all on ground. 

There is still a long way to go for us to start harvesting the fruits of the Tobacco Control Act, 2015. Massive sensitization about it should be done, and enforcement of the same should be felt because much of the population is not aware of its existence, some still ignorantly break the laws and since they are not held accountable, they get away with it but the harm is already done. Incentives should also be given to tobacco farmers so they can channel their energies elsewhere, you cannot block their source of livelihood without giving them an option, they should also be clearly educated about the harm that they are causing the world by embarking on tobacco farming. These among other measures can go a long way in the fight against lung cancer.

The writer is an Intern in the Strategic litigation programme at the Center for Health, Human Rights and Development (CEHURD).

Hepatitis Can’t Wait for COVID-19 to go

While the world seems to be drowning in the routine of infections, Covid-19 being the latest devourer, 500 million people are estimated to be infected with Hepatitis B or C worldwide according to the World Health Organization.

Compiled By Jacqueline twemanye

While the world seems to be drowning in the routine of infections, Covid-19 being the latest devourer, 500 million people are estimated to be infected with Hepatitis B or C worldwide according to the World Health Organization. These viruses kill 1.5 million people a year; 1 in every 3 people has been exposed to either or both B and C, while others suffer from alcoholic hepatitis. Unfortunately, most infected people are asymptomatic, that is, they have no or barely any symptoms of infection.

World Hepatitis Day is observed each year on 28th July to draw attention to the viral hepatitis, an inflammation of the liver that causes severe liver disease and hepatocellular cancer.

This year’s (2021) World Hepatitis Day theme “Hepatitis Can’t Wait”, conveys the urgency of efforts needed to eliminate hepatitis as a public health threat.

In Uganda, Hepatitis B infection is highly endemic according to findings from a national serosurvey. With a person dying every 30 seconds from a hepatitis related illness, even in the current COVID-19 crisis – we cannot wait to act.

The Government of Uganda is however applauded for its efforts towards the fight against Hepatitis B. Over 23 million adults and adolescents have been screened for the disease across the country, while 17.6 million adults and adolescents have been successfully vaccinated against Hepatitis B since the mass vaccination campaign was rolled out in 2015 as reported by Ministry of Health, although the target still remains unmet. Vaccination for Hepatitis B is still ongoing in public health facilities across the country for persons above nineteen years of age.

This killer disease is commonly caused by viral infection, abuse of alcohol, drugs, toxins, autoimmune hepatitis (where anti-bodies form against your liver tissue), exposure to infected bodily fluids. You may lower the risk of getting hepatitis by avoiding risky behaviours, such as sharing needles, having unprotected sex and drinking large amounts of alcohol.

Treatment options vary depending on which type of hepatitis you have. Some forms of hepatitis can be prevented through vaccination and lifestyle precautions.

Most people have no symptoms. However, those who develop symptoms may have fatigue, nausea, fever, dark urine, abdominal pain, loss of appetite and yellowing of the skin and eyes (jaundice). In cases of Alcoholic hepatitis, an increase in stomach size due to fluid accumulation.

In escalated conditions one may experience liver failure, cancer or scarring.

A call goes out to global, regional, national leaders, policy makers, communities and other stakeholders to explore opportunities for accelerating the hepatitis response to achieve elimination by 2030.

The writer is a Communications Officer at the Center for Health, Human Rights and Development (CEHURD).