Cover Image
close this bookSafe Blood in Developing Countries - The Lessons from Uganda (EC, 1995, 151 p.)
View the document(introduction...)
View the documentQuotation
View the documentForeword by the Uganda Minister of Health
close this folderForeword by Commissioner Professor Pinheiro
View the document(introduction...)
View the documentWhat the blood transfusion service has done for Kabarole hospital
View the documentSome facts about Uganda
close this folderSection One - Introduction and summary
close this folderChapter One - Safe blood and HIV/AIDS: The Uganda achievement
View the document(introduction...)
View the documentThe tragedy of the haemophiliacs
View the documentInfections carried by blood
View the documentThe unique features of Africa
View the documentThe global blood safety initiative
View the documentThe Uganda blood transfusion service: A portrait
View the documentThe wider contribution of the UBTS
View the documentThe view from an up-country hospital
View the documentThe matter of costs
View the documentThe dynamics of the project
View the documentA complex organisation
View the documentA view from Mulago hospital, Kampala
View the documentFour questions about AID
View the documentThe first visit for the EC
View the documentDr John Watson-Williams enters the scene
close this folderSection Two - Background: Uganda's history, health, and the HIV/AIDS epidemic
close this folderChapter Two - Uganda's political and physical health: A brief history
View the documentA. The political background
View the documentB. The health of the nation
View the documentC. Safe and unsafe blood in Uganda
close this folderChapter Three - AIDS in Uganda: A glimmer of hope?
View the document(introduction...)
View the documentExtent of aids in Uganda
View the documentMobilising to deal with HIV/AIDS
View the documentThe evidence for 'a glimmer of hope'
View the documentVoluntary mass HIV testing as a route to behaviour change
close this folderSection Three - The story of the Uganda blood transfusion service
close this folderChapter Four - How the European commission got involved
View the document(introduction...)
View the documentDr Lieve Fransen's report
View the documentThe 1987 plan
View the documentThe 1987 starting position
View the documentThe role of the Red Cross
close this folderChapter Five - Phase one of the project 1988-1990
View the document(introduction...)
View the documentA plan for blood donors
View the documentThe problem of laboratory space
View the documentThe problem of staffing
View the documentStaff structure and training
View the documentThe need for special skills
View the documentReconstruction of the Nakasero building
close this folderChapter Six - Phase two: Creation of a national service 1990-1991
View the document(introduction...)
View the documentRole of other donors
View the documentStaff recruitment
View the documentRegional blood banks
View the documentVoluntary testing for HIV
View the documentSupervision and quality control
close this folderSection Four - Evaluation: The view from Kampala
close this folderChapter Seven - The costs and benefits of safe blood in Uganda
View the documentA. The costs
View the documentB. The benefits to HIV prevention
View the documentC. Some other benefits
close this folderChapter Eight - Interview with Dr Peter Kataaha, Director, Uganda blood transfusion service
View the document(introduction...)
View the documentFlying to the rescue
View the documentChapter Nine - Interview with Dr Samuel Okware
close this folderSection Five - Key issues in blood transfusion: The Uganda experience
close this folderChapter Ten - The search for safer blood and the drive for voluntary, unpaid blood donors
View the document(introduction...)
View the documentCosts of relatives versus volunteers
View the documentFuture strategies: Donor clubs
close this folderChapter Eleven - The organisation of a blood transfusion service
View the document(introduction...)
View the document1. A centralised organisation
View the document2. A regional system
View the document3. A hospital-based system
View the document4. A mixed system
View the documentThe Zambian solution
close this folderChapter Twelve - Blood transfusion takes many skills: The importance of training
View the document(introduction...)
View the documentA. Training of Nakasero staff
View the documentB. Training of hospital staff
View the documentC. Residential courses for hospital staff
View the documentD. Training at schools for medical assistants
View the documentE. Training of senior professional staff
close this folderChapter Thirteen - Other issues, and their solutions
View the document(introduction...)
View the document1. Which diseases are screened against - and which are not? and why not?
View the document2. The special problem of malaria
View the document3. Adapting laboratory methods
View the document4. The start-up equipment - and computer
View the document5. Transport, for people, supplies, and blood
View the document6. Voice and data communications - or lack of
View the document7. Funding staff salaries in a time of inflation
View the document8. Keeping records, or trying to
View the document9. All or only some hospitals?
View the documentThe editor adds:
close this folderAppendices
View the documentAppendix 1: EC support for safe blood in developing countries
View the documentAppendix 2: Useful references

B. The health of the nation

Over half of Uganda's 17 million population, even under peacetime conditions, still falls below a basic poverty line. Life expectancy, at 47 years for men and 50 for women, is one of the lowest in the world. The country's crude death rate, at 20 per 1,000, is about twice the level of the average low-income country, for example, neighbouring Kenya. Over half of hospital deaths are children, the main killers being malaria, pneumonia, diarrhoea and malnutrition. Nearly half the children under 5 years of age suffer from malnutrition. For adults, the main causes of death are AIDS, tuberculosis and malaria.


Photo


Child receiving blood transfusion

'The leading causes of death are all preventable, although with varying degrees of difficulty,' comments the World Bank. One difficulty is the inadequate number of nurses and doctors - see the table. There are only around 90 hospitals for the whole country. Another problem is the health budget. Total health spending in Uganda, public and private added together, is about US$ 6 per head of population, which is a half to a third of what sub-Saharan countries in general spend, and half of what is considered necessary to provide a basic essential health service in a low-income country. Uganda's health problems are compounded by a high fertility rate and so a high population growth rate. But the toll this exacts on Uganda's mothers is high, with 550 maternal deaths per 100,000 live births, about twelve times the rate in developed countries. On top of all this came 'slim disease,' as Ugandans graphically describe the AIDS epidemic which hit the country.