Original Research

Effectiveness of the credit-line approach for support of CD4 equipment functionality in northern Uganda

Michael L. Kasusse, Nazarius M. Tumwesigye, Steven Aisu, Joseph K.B. Matovu, Rhoda Wanyenze
African Journal of Laboratory Medicine | Vol 4, No 1 | a234 | DOI: https://doi.org/10.4102/ajlm.v4i1.234 | © 2015 Michael L. Kasusse, Nazarius M. Tumwesigye, Steven Aisu, Joseph K.B. Matovu, Rhoda Wanyenze | This work is licensed under CC Attribution 4.0
Submitted: 27 August 2014 | Published: 30 November 2015

About the author(s)

Michael L. Kasusse, Makerere University School of Public Health, Kampala Uganda and MakSPH-CDC Fellowship Program, Makerere University School of Public Health, Kampala, Uganda
Nazarius M. Tumwesigye, Makerere University School of Public Health, Kampala, Uganda
Steven Aisu, Central Public Health Laboratories, Ministry of Health Uganda, Kampala, Uganda
Joseph K.B. Matovu, Makerere University School of Public Health, Kampala, Uganda and MakSPH-CDC Fellowship Program, Makerere University School of Public Health, Kampala, Uganda
Rhoda Wanyenze, Makerere University School of Public Health, Kampala, Uganda and MakSPH-CDC Fellowship Program, Makerere University School of Public Health, Kampala


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Abstract

Background: Improving laboratory service delivery requires a functioning logistics and supply system. Uganda’s Ministry of Health uses the credit-line approach to provide laboratory supplies including commodities for CD4 test equipment.

Objectives: We examined the effectiveness of the credit-line approach in improving laboratoryservice delivery by using the functionality of CD4 test equipment as a proxy indicator.

Method: A cross-sectional survey was conducted at 7 level-three health centres (HC IIIs), 18 level-four health centres (HC IVs), and 10 hospitals in 15 districts of mid-northern Uganda, including the Lango (17 facilities) and Acholi sub-regions (18 facilities), between July 2013 and August 2013. Functionality, was determined through self- and interviewer-administered questionnaires. The chi-squared test was used to assess differences in functionality by subregion, facility type, and equipment type.

Results: A total of 38 CD4 test analysers were assessed. Of these, 26 (68%) were functional. In hospitals, 85% of CD4 analysers were functional, in HC IVs, 67% were functional and in HCIIIs, 43% were functional. The differences did not reach statistical significance. In the Langosub-region, 72% of analysers were functional; in the Acholi sub-region, 65% were functional. Non-functionality was mainly due to lack of reagents and cartridges, as well as low staffing levels of laboratory technicians with the skills necessary to operate the equipment.

Conclusion: The credit-line approach supported the functionality of CD4 equipment in the surveyed facilities. However, there is a need to address issues of staffing and availability of reagents to enhance the functionality of CD4 equipment and improve patient care, especiallyat HC IIIs.


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