Stakeholder views on continuing professional development for doctors working in public primary care facilities in central Uganda: a qualitative study.

Introduction: the primary care workforce in the public sector of Uganda is under the district health system. The doctors in this workforce provide leadership and frontline promotive, preventive, curative, rehabilitative, and palliative care. Their numbers are still low and therefore need effective support through continuing professional development (CPD). Part of the support is influenced by stakeholders whose views on CPD in the district health system are important. This study therefore explored the stakeholders' views on the CPD of doctors working in the district health system in central Uganda. Methods: a qualitative exploratory study was done, and data was collected using an interview guide through in-depth interviews among ten purposively selected CPD stakeholders influencing different aspects of CPD activities of doctors working in public general hospitals and health center IVs. The interviews were recorded and transcribed verbatim and manually analyzed using deductive thematic analysis. Results: five themes were categorized into; CPD practices, facilitators, benefits, challenges, and suggestions. Each of the themes had subthemes; CPD practices; training, mentorship and apprenticeship, support supervision, and quality improvement projects. Facilitators; internet services, grants, health facility managers, facility-based CPD providers, and regional CPD guidelines. Benefits; motivation, knowledge, teamwork, and renewal of practicing licenses. Challenges; workload, allowances, access, documentation, mindset, quality, structure of public health system, and sustainability. Suggestions; training needs analysis, collaboration, monitoring, e-CPD platforms, CPD resource centers, and individual CPD responsibility. Conclusion: the stakeholders' views are an indication that effective CPD is a collaborative effort from both the primary care doctors and those in the leadership of the health care system.

Continuing professional development training needs for primary care doctors in central Uganda.

BACKGROUND: Continuing professional development (CPD) activities relevant to medical doctors and their patients should be informed by current assessed training needs. The CPD provision is expected to improve the quality of professional practice and ethics. However, the Uganda Medical and Dental Practitioners' Council still receives about 40 reports of malpractice every month. AIM: The study aimed to describe the CPD training needs of doctors working in public primary care facilities in central Uganda. SETTING: The district health system of central Uganda comprised 10 General Hospitals (GH) and 37 Health Center IVs (HC IVs) with a staffing norm of six and two doctors, respectively. METHODS: This was a cross-sectional survey of 100 doctors working in public primary care facilities using the World Health Organization (WHO) Hennessy-Hicks questionnaire. Descriptive statistics of the importance, current performance, and training need of each skilled activity were calculated. Content analysis was applied to data from the open-ended questions. RESULTS: The response rate was 91%, majority were males, 80 (87.9%) from 7 GHs and 24 HC IVs with an average age of 37.9 years. The domain with the highest CPD training need for the doctors was research and audit, with a mean score (standard deviation [s.d.]) of 1.94 (±1.69), followed by administration 1.58 (±1.61) and clinical tasks 1.28 (±1.29). The clinical tasks domain had the most suggested CPD topics. CONCLUSION: Research and audit and clinical tasks were identified as important domains for CPD training for doctors in this setting.Contribution: The results give insight into CPD training needs of primary care doctors and guide various CPD providers.

Social support from family, associated factors and relationship with glycemic control among diabetic patients in Uganda: a cross-sectional study.

Introduction: social support from family members in diabetes management is a predictor of optimal glucose control. There is limited evidence of the relationship in Uganda. The objective was to determine association of social support from family and glycemic control, and association of social demographic and clinical characteristics with family support among diabetic patients in eastern Uganda. Methods: this was a cross-sectional study involving 405 adult patients attending diabetic clinics between May 2021 and June 2021. Socio-demographics, clinical characteristics, social support from family, and glycemic control data were collected. Descriptive statistics were done and associations were determined using Pearson chi-square and Fisher´s exact tests. Generalized linear model was used to determine independent association with social support from family. Results: the mean age was 52 years, (60%) were female, majority (49.4%) were 45-64 years old. Perceived social support from family (PSS-fa) and good glucose control were found in; (95.3%) and (20.99%) respectively. PSS-fa was associated with good glucose control. Financial contribution from family members to cost of care, cohesion among family members in support of care, being (married/cohabiting) and monthly income ≥28 USD were associated with PSS-fa. Factors independently associated with PSS-fa were; female gender, financial contribution to cost of care and cohesion among family in support of care. Conclusion: social support from family was associated with good glycemic control. Factors associated with PSS-fa were; female gender, financial contribution from family to cost of care and cohesion among family in support of care.

The relationship between perceived social support from family and diabetes self-management among patients in Uganda.

Introduction: optimal self-care in diabetes mellitus contributes substantially to good glucose control and delays development of complications. The family´s support is an important predictor of optimal self-care behavior. Little is known about the relationship between social support from family and self-care behavior in Uganda. The study set out to determine the association between perceived social support from immediate family and diabetes self-management among diabetic patients in the eastern region of Uganda. Methods: this was a cross-sectional study among 405 adults attending diabetic outpatient clinics in Eastern Uganda between May 2021 and June 2021. Data of socio-demographic and clinical characteristics, perceived social support from family, and diabetes self-management were collected. Descriptive statistics were done and associations of socio-demographic and clinical characteristics, perceived social support from family with diabetes self-management were determined using Pearson Chi-square and Fisher´s exact tests. Results: the mean (SD) age was 52 (14.9) years, (60%) were female, majority (49.4%) were 45-64 years old. Perceived social support from family and optimum diabetes self-management were found in; (95.3%) and (87.4%) respectively. Perceived social support from family was associated with optimal diabetes self-management (p-value <0.001). Financial contribution from family members to cost of care and cohesion among family members in support of care were associated with optimal diabetes self-management both with a (p-value 0.001). Access to a functional glucometer was associated with optimal diabetes self-management (p-value <0.001). Conclusion: among patients in Eastern Uganda, self-management for diabetes control is significantly associated with perception of receipt of support from their families.