Building High-Quality Critical Care in Uganda

The Government of Uganda is undertaking an ambitious effort to increase critical care capacity by fully equipping ICUs at all regional referral hospitals across the nation.

Photo Cation/Credit: ICU at Lira Regional Referral Hospital/Government of Uganda

We’re proud the Gradian Comprehensive Care Ventilator (Gradian CCV) and our model of robust training and biomedical can support this critical moment and the partners on the frontlines, such as the Association of Anesthesiologists of Uganda (AAU) and Joint Medical Store (JMS)—a leading medical device and pharmaceutical distributor—making this change a reality for the nation’s COVID-19 response and future health system strength.

The AAU and JMS recently produced a series of short video interviews with anesthesiologists and intensive care specialists about the current state and future vision of critical care in Uganda and what it’ll take to get there, from policy to equipment to education and tackling the biggest challenges to progress.

An Ambitious Vision and Plan

 Dr. Arthur Kwizera, Mulago National Referral Hospital, Makerere University College of Health Sciences, AAU Uganda and Intensive Care Society of Uganda

Dr. Arthur Kwizera is an anesthesiologist and intensive care specialist at Mulago National Referral Hospital, a lecturer at the Department of Anesthesia and Intensive Care at Makerere University College of Anesthesia, AAU member, and president of the Intensive Care Society of Uganda. Kwizera discusses how the government, the AAU, and partners like Gradian Health Systems are growing the country’s intensive care capacity.

“This will help us build the capacity that we need to provide intensive care services in regional environments, district hospitals as well as health center[s].”

Key video highlights:

• Education pipeline: Embedding intensive care into the current anesthesia specialist training to increase the number of anesthesia providers available to provide care in regional and district hospitals and creating a new critical care nursing program to train 1,000 nurses
• Infrastructure expansion: Building at least 18 fully operational intensive care units (ICUs) at regional referral hospitals to create a total of 180 ICU beds (10 per ICU)
• National policy alignment: Developing a National Surgical, Obstetric and Anesthesia Plan for Uganda

Watch the video and read its transcript here.

The State of Affairs and What’s Needed

Dr. Mary Nabukenya, Anesthesiologist and Critical Care Specialist, Mulago National Referral Hospital and Makerere University College of Health Sciences

Dr. Mary Nabukenya is an anesthesiologist and a critical care specialist at Mulago National Referral Hospital and a lecturer at Makerere University and, in this video, discusses the current state of ICU bed distribution across Uganda, specific plans for ICU expansion, and the role the Gradian CCV is playing in supporting this increase in capacity.

“And these are not ICUs that are just created for COVID, but we hope they will continue to work even after COVID has been managed.”

Key video highlights:

• Previous ICU bed capacity and distribution: Prior to the expansion, there were approximately 55 ICU beds across 12 ICUs in Uganda according to a 2019 study, and the vast majority of these (83 percent) and 80 percent of anesthesiologists—who are needed to run ICUs—are clustered in Uganda’s capital city Kampala
• Expanding across all regions: The Ministry of Health is setting up an ICU in each of the country’s 14 regions and is acquiring Gradian CCVs for each ICU because of their oxygen flexibility, multiple sources of power, ease of use, and
• A national training effort: The AAU will train anesthesiologists, specialists, and all the medical officers and nurses in these hospitals (only a small fraction of the country’s approximately 170 nurses working in ICUs are formally trained in critical care)

Watch the video and read its transcript here.

Uganda Critical Care Training

Dr. Fredfly Bulamba, Anesthesiologist, CURE Children’s Hospital Uganda and Busitema University FHS

Dr. Fredfly Bulamba is an anesthesiologist at CURE Children’s Hospital Uganda, a lecturer at Busitema University, and is helping lead helping lead training activities in support of the government’s national critical care expansion effort, including a new critical care training program at regional referral hospitals receiving Gradian CCVs. Key video highlights:

• The critical care training program blends online and on-site training and staggers training sessions to enable health care providers to learn during their shifts while ensuring care coverage in wards
• The importance of building a strong foundation around the basic therapies of critical care
• To need to increased partnership and advocacy to increase the training pipeline for critical care nurses and physicians

Watch the video and read its transcript here.

The Hospital Experience

Dr. Eric Odwar, Anesthesiologist, St. Mary’s Hospital Lacor

Dr. Eric Odwar is an anesthesiologist at St. Mary’s Hospital Lacor in Gulu, Uganda. Lacor’s ICU sees an average of five to seven patients every week and has had Gradian CCV’s since 2019. Lacor is one of the hospitals having their ICU bed and ventilator capacity increased under the national critical care expansion. Key video highlights:

• Critical need for human resources: There is a critical need to expand human resources, including intensivists, anesthesiologists, anesthetists, and biomedical engineers
• Gradian CCV: The Gradian CCV’s durability, long battery life (21 hours), and quick start modes support health care provides more quickly provide

Watch the video and read its transcript here.