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International Journal for Quality in Health Care Advance Access published online on September 30, 2009
International Journal for Quality in Health Care, doi:10.1093/intqhc/mzp044
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© The Author 2009. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved

Incentives and barriers to implementing national hospital standards in Uganda

Moses Bateganya1, Amy Hagopian1, Paula Tavrow2, Samuel Luboga3 and Scott Barnhart1

1 Department of Global Health, University of Washington, Seattle, WA, USA
2 Department of Public Health, University of California, Los Angeles, CA, USA
3 Department of Anatomy, Makerere University, Kampala, Uganda

Objective. The objective of this study was to elicit hospital staff's knowledge, attitudes, and current practices regarding hospital standards and to assess the level of motivation for staff and hospitals to meet new standards.

Design. This was a qualitative study using in-depth interviews and focus group discussions with staff in four hospitals. There was no intervention.

Setting. Four rural public and private not-for-profit hospitals in central Uganda.

Participants. Medical superintendents and other staff of four hospitals in Uganda who were familiar with the use of standards and had participated in a previous Uganda national accreditation program (Yellow Star).

Results. All staff expressed strong support for the development and implementation of hospital standards, but also said they would need more recognition and ongoing motivation. They cited the need for technical assistance, funding, and training as the main obstacles. Key areas requiring standards were: infection control, cleanliness and hygiene, infrastructure and medical records.

Conclusions. There was strong support for the development and implementation of hospital standards. The main perceived obstacles to the implementation of hospital standards are resource limitations and technical capability. There is a need to develop and implement preliminary standards for hospitals in Uganda.

Keywords: accreditation, developing countries, standards, hospitals, Uganda

Address reprint requests to: Moses Bateganya, Department of Global Health, University of Washington, 901 Boren Avenue, Suite 1100, Seattle, WA 98104, USA. Tel: +1-206-446-7295; Fax: +1-206-221-4945; E-mail: bategm{at}u.washigton.edu, bmh_h{at}yahoo.com

Accepted for publication September 13, 2009.


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