Abstract:
OBJECTIVE:The purpose of this study was to determine the current work distribution of health professionals from a public Ugandan medical school in a period of major donor funding for HIV programmes. We explore the hypothesis that programmes initiated under unprecedented health investments from the US President's Emergency Plan for AIDS Relief have possibly facilitated the drain of healthcare workers from the public-health system of countries like Uganda. DESIGN:Cross-sectional study conducted between January and December 2010 to survey graduates, using in-person, phone or online surveys using email and social networks. Logistic regression analysis was applied to determine ORs for association between predictors and outcomes. SETTING:Located rurally, Mbarara University of Science and Technology (MUST) is one of three government supported medical schools in Uganda. PARTICIPANTS:Graduates who completed a health-related degree at MUST. MAIN OUTCOME MEASURE:Location of health profession graduates (Uganda or abroad) and main field of current job (HIV-related non-governmental organisation (NGO) or others). RESULTS:We interviewed 85.4% (n=796) of all MUST alumni since the university opened in 1989. 78% (n=618) were physicians and 12% (n=94) of graduates worked outside Uganda. Over 50% (n=383) of graduates worked for an HIV-related NGO whether in Uganda or abroad. Graduates receiving their degree after 2005, when large HIV programmes started, were less likely to leave the country, OR=0.24 (95% CI 0.1 to 0.59) but were more likely to work for an HIV-related NGO, OR=1.53 (95% CI 1.06 to 2.23). CONCLUSIONS:A majority of health professionals surveyed work for an HIV-related NGO. The increase in resources and investment in HIV-treatment capacity is temporally associated with retention of medical providers in Uganda. Donor funds should be channelled to develop and retain healthcare workers in disciplines other than HIV and broaden the healthcare workforce to other areas.
journal_name
BMJ Openjournal_title
BMJ openauthors
Bajunirwe F,Twesigye L,Zhang M,Kerry VB,Bangsberg DRdoi
10.1136/bmjopen-2013-002875subject
Has Abstractpub_date
2013-05-31 00:00:00issue
5issn
2044-6055pii
bmjopen-2013-002875journal_volume
3pub_type
杂志文章相关文献
BMJ Open文献大全abstract:INTRODUCTION:People living with and beyond cancer are vulnerable to a number of physical, functional and psychological issues. Undertaking a holistic needs assessment (HNA) is one way to support a structured discussion of patients' needs within a clinical consultation. However, there is little evidence on how HNA impac...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmjopen-2014-006840
更新日期:2015-05-11 00:00:00
abstract:OBJECTIVES:To assess the impact of both the Committee on Safety of Medicines (CSM) warning (December 2003) and the National Institute for Health and Care Excellence (NICE) guidance (September 2005) on antidepressant prescription rates in children and adolescents within the UK primary care service. SETTING:Population b...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-028201
更新日期:2019-08-07 00:00:00
abstract:INTRODUCTION:Hearing loss is a common chronic problem which can be effectively managed with hearing devices. At present, only a limited number of people with hearing loss use hearing aids (HAs) and cochlear implants (CIs) to improve hearing and sound quality and enhance quality of life. Clinical equipoise, by which we ...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-030100
更新日期:2019-09-08 00:00:00
abstract:INTRODUCTION:Community-based interventions have been found to effectively increase the implementation of alcohol management practices and reduce excessive alcohol use and alcohol-related harm at sports clubs. However, once implementation support ceases there may be a reduction in such intervention effects. Thus, ongoin...
journal_title:BMJ open
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmjopen-2017-017796
更新日期:2018-01-23 00:00:00
abstract:INTRODUCTION:While tobacco smoking prevalence is falling in many western societies, it remains elevated among high-priority cohorts. Rates up to 95% have been reported in women whose pregnancy is complicated by other substance use. In this group, the potential for poor pregnancy outcomes and adverse physical and neurob...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究
doi:10.1136/bmjopen-2019-032330
更新日期:2019-11-21 00:00:00
abstract:OBJECTIVES:The aim of the study was to examine the level of patient satisfaction with nursing care and identify the factors affecting satisfaction from the inpatient's perspective in a backward region of China. DESIGN:This was a cross-sectional study. SETTING:The study was conducted at a tertiary hospital located in ...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-034196
更新日期:2020-09-09 00:00:00
abstract:INTRODUCTION:Chronic lower back pain (CLBP) is a major healthcare problem with wide ranging effects. It is a priority for appropriate management of CLBP to get individuals back to work as early as possible. Interventions that identify biopsychosocial barriers to recovery have been observed to lead to successfully reduc...
journal_title:BMJ open
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmjopen-2015-010407
更新日期:2016-05-26 00:00:00
abstract:OBJECTIVES:To describe the clinical profile of Brazilian patients with type 2 diabetes attending the public healthcare system and identify factors associated with poor glycaemic control. DESIGN:Cross-sectional study. SETTING:14 centres in five regions of Brazil, including primary care units and outpatient clinics of ...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2013-003336
更新日期:2013-09-18 00:00:00
abstract:INTRODUCTION:Patients with difficult venous access experience undesirable effects during healthcare, such as delayed diagnosis and initiation of treatment, stress and pain related to the technique and reduced satisfaction. This study aims to identify risk factors with which to model the appearance of difficulty in achi...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究
doi:10.1136/bmjopen-2017-020420
更新日期:2018-02-08 00:00:00
abstract:INTRODUCTION:Multiple sclerosis (MS) is a severe debilitating disease that affects patients' quality of life. Up to 90% of patients with MS will develop lower urinary tract dysfunction within the first 18 years of the disease. If oral pharmacotherapy with anticholinergics, behavioural modifications and pelvic floor phy...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2016-013225
更新日期:2017-02-03 00:00:00
abstract:INTRODUCTION:One in five men is likely to receive a diagnosis of prostate cancer (PCa) by the age of 85 years. Men diagnosed with low-risk PCa may be eligible for active surveillance (AS) to monitor their cancer to ensure that any changes are discovered and responded to in a timely way. Communication of risk in this co...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2017-017372
更新日期:2017-10-05 00:00:00
abstract:INTRODUCTION:Recent studies suggest that endoplasmic reticulum stress may play a critical role in the pathogenesis of amyotrophic lateral sclerosis (ALS) through an altered regulation of the proteostasis, the cellular pathway-balancing protein synthesis and degradation. A key mechanism is thought to be the dephosphoryl...
journal_title:BMJ open
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmjopen-2016-015434
更新日期:2017-08-11 00:00:00
abstract:OBJECTIVES:The choice of doctor is an important issue for patients with cancer, and the reputation of the doctor is the single most important factor for patients to choose a doctor. Media are providing information about the 'best cancer doctor', but they vary widely in their selection methodology. We investigated cance...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究
doi:10.1136/bmjopen-2017-019067
更新日期:2018-05-14 00:00:00
abstract:OBJECTIVES:Compared with controls, multiple sclerosis (MS) patients die, on average, 7-14 years prematurely. Previously, we reported that, 21 years after their participation in the pivotal randomised, controlled trial (RCT) of interferon β-1b, mortality was reduced by 46-47% in the two groups who received active therap...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2012-001972
更新日期:2012-11-30 00:00:00
abstract:OBJECTIVES:This study aimed to identify intrauterine growth differences according to infertility treatment compared with spontaneous conception and to describe intrauterine growth trajectories. DESIGN:Retrospective cohort study. SETTING:A single primary and tertiary medical centre in Japan. PARTICIPANTS:This study i...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-033675
更新日期:2020-04-28 00:00:00
abstract:OBJECTIVE:To explore the prevalence and combined cardiovascular risk factors of prehypertension in southern China. DESIGN:A retrospective study; the logistic regression model was used to find the risk factors of prehypertension. SETTING:The study was conducted in Shunde District, southern China, using the community-b...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2014-006551
更新日期:2014-11-13 00:00:00
abstract:INTRODUCTION:Multifarious chronic obstructive pulmonary disease (COPD) guidelines have been published by local, national and global respiratory societies. These guidelines subsume holistic evidence based on recommendations to diagnose, treat, prevent and manage acute exacerbation with COPD. Despite the existing compreh...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-036060
更新日期:2020-07-20 00:00:00
abstract:INTRODUCTION:While patient and citizen engagement has been recognised as a crucial element in healthcare reform, limited attention has been paid to how best to engage seniors-the fastest growing segment of the population and the largest users of the healthcare system. To improve the healthcare services for this populat...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2015-008190
更新日期:2015-11-03 00:00:00
abstract:AIM:To estimate the population attributable risk (PAR) for Chlamydia trachomatis infection in young men and women in Sydney, Australia. METHOD:Multivariate logistic regression was used to examine the association between demographic, sexual behaviour and other potential risk factors and chlamydia positivity in young (≤...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2010-000004
更新日期:2011-02-23 00:00:00
abstract:OBJECTIVE:Financial incentives may encourage private for-profit providers to perform more caesarean section (CS) than non-profit hospitals. We therefore sought to determine the association of for-profit status of hospital and odds of CS. DESIGN:Systematic review and meta-analysis. DATA SOURCES:MEDLINE, EMBASE and the...
journal_title:BMJ open
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmjopen-2016-013670
更新日期:2017-02-17 00:00:00
abstract:OBJECTIVES:To prevent pain inhibiting their performance, many athletes ingest over-the-counter (OTC) analgesics before competing. We aimed at defining the use of analgesics and the relation between OTC analgesic use/dose and adverse events (AEs) during and after the race, a relation that has not been investigated to da...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2012-002090
更新日期:2013-04-19 00:00:00
abstract:OBJECTIVES:We investigated the clinical characteristics of patients with stroke recurrence in the first year after cardioembolic stroke, and determined the predictors associated with recurrence. DESIGN:A prospective cohort study. SETTING:Multicentre study at the Fukuoka prefecture in Japan. PARTICIPANTS:We enroled 2...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2013-003678
更新日期:2013-11-14 00:00:00
abstract:OBJECTIVE:To investigate whether two primary care activities that are framed as indicators of primary care quality (comprehensive care plans and annual reviews of physical health) influence unplanned utilisation of hospital services for people with serious mental illness (SMI). DESIGN, SETTING, PARTICIPANTS:Retrospect...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-023135
更新日期:2018-11-28 00:00:00
abstract:OBJECTIVES:To identify the determinants of antenatal care (ANC) utilisation in sub-Saharan Africa. DESIGN:Systematic review. DATA SOURCES:Databases searched were PubMed, OVID, EMBASE, CINAHL and Web of Science. ELIGIBILITY CRITERIA:Primary studies reporting on determinants of ANC utilisation following multivariate a...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-031890
更新日期:2019-10-07 00:00:00
abstract:OBJECTIVES:Head injury is a common reason for emergency department (ED) attendance. Around 1% of patients have life-threatening injuries, while 80% of patients are discharged. National guidelines (Scottish Intercollegiate Guidelines Network (SIGN)) were introduced in Scotland with the aim of achieving early identificat...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究
doi:10.1136/bmjopen-2018-022279
更新日期:2018-12-22 00:00:00
abstract:OBJECTIVE:To examine the effect of an outdoor smokefree law in parks and on beaches on observed smoking in selected venues. METHODS:The study involved repeated observations in selected parks and beaches in Vancouver, British Columbia, Canada. The main outcome measure was changes in observed smoking rates in selected v...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2013-002916
更新日期:2013-06-20 00:00:00
abstract:OBJECTIVES:Despite evidence for an association between the built environment and physical activity, less evidence exists regarding relations between the built environment and sedentary behaviour. This study investigated the extent to which objectively assessed and self-reported neighbourhood walkability, in addition to...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2015-009418
更新日期:2015-11-25 00:00:00
abstract:OBJECTIVES:We examined the utility of January 2004 to April 2014 Google Trends data from information searches for cancer screenings and preparations as a complement to population screening data, which are traditionally estimated through costly population-level surveys. SETTING:State-level data across the USA. PARTICI...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2014-006678
更新日期:2015-06-08 00:00:00
abstract:INTRODUCTION:Postoperative ileus (POI) is a frequent complication after abdominal surgery (AS). Until today, neither a prophylaxis nor an evidence-based therapy exists. This originates from the absence of objective parameters evaluating the severity and duration of POI resulting in clinical trials of modest quality. Th...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2015-011014
更新日期:2016-07-08 00:00:00
abstract:INTRODUCTION:Up to half of all smokers develop clinically significant chronic obstructive pulmonary disease (COPD). Gaps exist in the implementation and uptake of evidence-based guidelines for managing COPD in primary care. We describe the methodology of a cluster randomised controlled trial (cRCT) evaluating the effic...
journal_title:BMJ open
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmjopen-2017-016985
更新日期:2017-09-18 00:00:00