Assessment of factors associated with district health facility preparedness towards cholera epidemics: A case of Namayingo District, Uganda

Abstract

Background: African countries are prone to epidemics due to poor preparedness. Uganda adopted the Integrated Disease Surveillance and Response (IDSR) strategy to effectively respond to epidemics. Despite having an IDSR, Namayingo district has repeatedly experienced annual cholera outbreaks. The outbreaks result into unexpected government expenditure with a negative effect on people‘s health and economic welfare. Objective. To assess the district health facilities preparedness to respond to cholera outbreaks in Namayingo district. Methodology; A cross sectional quantitative study was conducted in all the public health facilities in Namayingo District. A total of 231 health workers were interviewed using a structured questionnaire adopted from the IDSR tool. Data were captured using Microsoft excel and analyzed using Stata 14.0. The median IDSR scores was used to determine preparedness. Logistic regression analysis was carried out to identify factors associated with preparedness. Results: The District preparedness to respond to cholera outbreak was 38.10%. Factors significantly associated with preparedness included; age, educational level, profession, years of service, duration in current facility, being resident within a facility, grade and location of health facility, and presence of hand washing facilities and detergents. Slightly more than half (51.52% 95%CI 45.02-58.01) of the health workers were knowledgeable on cholera. Conclusion and Recommendations: The District preparedness to respond to cholera was poor. Health care services in lower and rural health facilities should be upgraded including provision of washing facilities. Trainings on IDSR should be offered to Staff with lower levels of education should be offered IDSR training.