Innovative health service delivery in government hospitals in Uganda : a case of Kabale and Kambuga hospitals in Kigezi sub-region

Abstract

Innovations in health service delivery have over time addressed health education, rehabilitation, treatment, diagnosis and monitoring of health conditions. The aim is to improve healthcare quality, service availability, service affordability and access to healthcare. This study investigated how innovations (ICT and Policies) influence health service delivery in Uganda’s government hospitals with a case study of the Kigezi sub-region. Diffusion of Innovation Theory, Four-Level Model of Healthcare and Control Knobs Health System Model underpinned this study. The study used a cross-sectional case study design anchored on interpretivism paradigm. The findings were: (i) Uganda’s health industry has improved over time although there are serious challenges that impede public health service delivery, which include, inter alia, underfunding of the sector, shortage of drugs, human resource capacity gaps, poor attitude and mindset of health workers, commercialisation of the health sector, obsolete items and expired drugs, exploitation by the private sector, outdated health infrastructure and lack of coordination among health implementing partners; (ii) Innovative health service delivery ICT platforms, mainly mTrac, RX Solution and the Health Management Information System, positively contribute to speed, efficiency and quality of health services in government hospitals in Uganda; (iv) Decentralisation for health and Public Private Partnership for Health greatly influence speed, efficiency and quality of health services in government hospitals in Uganda. Public Private Partnership for Health was thin on the ground; (iii) Patient centered care (modern way of healthcare delivery) fosters a relationship between the healthcare team and the patient/patient caretakers, thus forging a “home”. However, Uganda has no legal and institutional frameworks to support of patient centered care. Basing on the gaps in the health service delivery models in Uganda, health challenges and responses from field, an Integrative Patients’ Quality Care Health Service Model was developed to fill the health service delivery gaps.