By Goodluck Musinguzi
Dr Sophie Namasopo, Director of Kabale Regional Referral Hospital is the accounting officer of all funds and programs. She reports to Parliament when accounting for the money received in a financial year.
Its hard to know her personal twitter account and Kabale Regional Referral Hospital has no account for feed back. While other accounting officers are active on social media Kigezi Region residents who use this facility might find it difficult to communicate with the leaders.
The MAIN OBJECTIVES AND OUT PUT OF KABALE REGIONAL REFERRAL HOSPITAL ARE,
“To provide quality and sustainable, general and specialized health services to all people of Kigezi Sub- Region. Supervision of lower health units, provision of quality health care, health promotion and disease prevention, spearhead operational research”.
Kabale Hospital built in 1946, is located in the central business district of the town of Kabale, approximately 139 kilometers by road, south-west of Mbarara Regional Referral Hospital. This is about 404 kilometers south-west of Mulago National Referral Hospital.
Dr Sophie Namasopo was the Head of Jinja Regional Referral Hospital before being transferred to Kabale Regional Referral Hospital.
Kabale Hospital is a public hospital, funded by the Uganda’s Ministry of Health though self accounting and general care in the hospital is free.
It is one of the thirteen regional referral hospitals in Uganda. The hospital is designated as one of the fifteen internship hospitals in Uganda where graduates of Ugandan medical schools can serve of internship under the supervision of qualified specialists and consultants.
In 2014, work to expand and renovate the hospital got underway, in anticipation of turning the hospital into the teaching hospital of Kabale University. The renovations include the construction of new operating rooms (surgical theatre), the upgrading and expansion of the maternity ward, and construction of a modern out-patients department. UGX:20 billion was budgeted for the work.
Kabale Hospital’s maternity ward is grappling with a congestion problem as the hospital struggles to accommodate expectant mothers from Kabale, Kisoro, Kanungu, Kisoro, Rukungiri and Ntungamo districts. “Self-referral” is a major problem by some expectant mothers who choose to come straight to the main hospital.
MEDIUM TERM PLANS
In the medium term, the hospital plans to complete equipping and furnishing the 115 bed private wing, embark on construction of a 10 apartment interns’ hostel and an orthopedic workshop.
The hospital also plans to improve on service delivery by attending to more patients, improving community outreaches, finalize the hospital master plan and implement the Patients’ Charter.
Measures to improve Efficiency, the plans to increase efficiency include;
1) Constant monitoring of the activities by management . 2)
Appointment of the project manager who in turn has to report to management.3) Internal audit control system must be strengthened. However the management is always monitoring the activities through spot
checks, supervision and mentoring to ensure value for money.
Performance for Previous Year FY 2018/19
- 15,352 inpatients were cumulatively seen, with a Bed Occupancy Rate (BOR) of 63% and an Average Length of Stay(ALoS) of 4.6 days. Major
operations including cesarean section were 2,219.
- Patients attended to in the general Outpatients Department and Grade A were 82,569, while in the Specialized Clinics 38,164 patients were
treated. Referrals in were 982 with 248 referrals out.
- As regards Emergency Medicines and other Health Supplies, items worth 1,247,396,558/- were received and dispensed.
- Under diagnostics, Laboratory tests carried out were 98,201, with 3,976 X-rays and 6,669 Ultrasound scans done on the patients.
- Prevention and Rehabilitation services, 4,350 Family Planning clients were attended. Antenatal Care (All attendances) were 5,848. Antenatal
Care (All visits) 3,182 mothers were attended to in the Maternal Child Health clinic.
- All Immunizations cumulatively were 20,710 while static immunizations were 8,655.
- Hospital Management conducted scheduled meetings included 9 Top Management, 3 Senior Management, 4 quarterly data review and 4
Hospital Management Board meetings were held. However, there were a number of other committee meetings including Contracts Committee and
monthly data review meetings.
- Human Resource Management services including timely payment of salaries and pension, periodic HR reports prepared and submitted including
data capture and payroll management. IPPS and biometric system were also handled.
- Finally, as regards Records Management as an output, periodic records reports were prepared and submitted in accordance with the set
guidelines. This was done after collecting data from the different clinical areas.
- Overall, approved budget for FY 2018/19 was 7.95bn/-, Released was 8.01bn/- (100.7%) and what was spent was 7.48bn/- (94.1%). Total
budget released was more because the hospital received a supplementary.
Performance as of BFP FY 2019/20 (Performance as of BFP)
- In regard to Quarter 1 performance, Out of the Total Approved Vote budget of 8.479bn/-, released was 2.455bn/- and spent to achieve the
- For inpatient services, admissions were 4,060 against a quarterly target of 3,738 with a Bed Occupancy Rate of 167.5% (target 80%) and an
Average Length of Stay of 3.9 days (target 4 days).
- Outpatient services; 34,730 outpatients were seen in general (quarterly target is 17,592). In the Specialized clinics 10,411 patients were handled
(quarterly target is 7,654). Referral cases in were 470, with 120 referrals out.
- Under diagnostics, 22,920 laboratory tests were conducted, x-rays were 996 and ultrasound scans were 1,754.
- Prevention and Rehabilitation, ANC (All attendances) were 1,587, ANC (All visits) were 814, number of children immunized (all
immunizations) were 5,526 and number of childhood vaccinations (all contact) given were 1,454. Family Planning (old and new) attendances were
- All identified HIV+ women were initiated on ART.
- As regards emergency medicines and other health supplies, the hospital received and dispensed items worth 269,328,565/- (Two hundred sixtynine million, three hundred twenty-eight thousand, five hundred sixty-five shillings).
- 55 Pensioners were paid every month for the 1st quarter. As regard salaries, 259 staff members were paid in July, 259 in August and 263 in
September 2019. But there were also a number of other payments made for supplies, works, consultancy and staff facilitation for various activities.
- A Hospital Management Board meeting and 3 Top Management meetings were held. Daily 24hr morning meetings were also convened including
monthly data review meetings as well as a quarterly data review meeting.
- About Capital Development, construction of the Interns¶hostel still continues and currently walling is being done for the 3rd floor and also
casting of the steel columns. Other projects planned for quarter one are still ongoing.
FY 2020/21 Planned Outputs
Planned outputs for Financial Year 2020/21 are as follow;
- Inpatient services: admissions 16887, Bed Occupancy Rate 90%, Average Length of Stay 4 days. Major operations including cesarean section
- Outpatient services: general OPD 96653, Specialized clinics 52980, referrals in 925, referrals out 273.
- Medicines and health supplies dispensed worth 1,250,772,864/-
- Diagnostic services: 11,3796, X-rays 4,393 and Ultrasound scans 7,336
- Prevention and Rehabilitation: antenatal cases (all attendances) 6,433, children immunized (all immunizations) 22,780, Family Planning users to
be attended to (old and
new) 4,785, number of ANC visits (All visits) targeted are 3,500 and all HIV positive pregnant women identified will be initiated on ART.
- Immunization services: childhood vaccinations targeted are 9,521
- Hospital Management and Support Services: 4 Hospital Management Board meetings, 1 Annual report, 4 quarterly financial, 12 Top
Management meetings were to be held. Also different committee meetings were to be supported to take place. The Asset Register will also be
updated. Salaries, pension as well as other payments will be done on time. Timely submission of quarterly financial/activity report will be done.
- Records management: 52 weekly reports (MTRAC and Option B reports), 12 monthly reports HMIS 105 (OPD), HMIS 108 (Inpatients), 4
HMIS 106 reports,1 Annual report. Also planned is issuing birth and death certificates.
- Regional maintenance workshop: 5,520 medical equipment including generators, repaired, serviced and maintained by the workshop. User
training conducted and a regional workshop meeting held.
- Internal Audit: 4 timely quarterly Internal Audit reports covering risk areas in the Internal Audit.
- Capital Development projects
Project: 1004 Kabale Regional Hospital Rehabilitation; continue with construction of the Interns¶hostel complex, and renovate plumbing
system of the Private Wing
Project: 1473 Institutional Support to Kabale Regional Referral Hospital: procure medical, ICT and office equipment. Some plants and machines
- During the medium term, the hospital will continue with construction of the Interns¶hostel. Currently, the hostel is at the level where they are
constructing walls for the third and last floor of the building. And also, the steel columns are continuously being cast. Implement other projects as
planned. These projects include medical records building, completion of the attendants¶shed, fencing of the adolescent clinic, constructing a
washing area for patients¶attendants. We also plan to go ahead and procure assorted medical equipment as per the lists submitted by the users.
- Continue offering health services to the population in Kigezi region regardless of their gender by ensuring smooth running of the hospital.
Through effective coordination of planned activities and budget implementation.
- Also keep on maintaining medical equipment in the catchment areas as well as conducting regional meetings to keep in touch with other health
facilities to aid in preventive maintenance and repairs.
- Conduct radio programs as a way of keeping the people informed about health issues and operations of the hospital and also government health
- Continuous Quality Improvement (CQI) is key for provision of health services, therefore as a hospital we shall continue with and even strive to
graduate to Total Quality Management (TQM).
- The component of support supervision is continuous and it shall still be carried out both within the hospital and other health facilities. This is
aimed at doing away with unwanted health outcomes that include referral in of laboring mothers in poor conditions, which may result in maternal
and neonatal deaths.
- Performance improvement endeavors increased through not only performance appraisal but also staff performance reviews to ensure maximum
achievement of planned outputs.