For a health facility to provide all-round quality services, they should have in place the right equipment functioning optimally. For this reason, to promote appropriate use, regular repair is critical to increase lifespan, decrease break downs as well as reduce losses and wastages. The Regional maintenance teams are required to provide routine maintenance and backstopping of equipment at health Centre IVs, and with the ongoing implementation of the Belgian supported Leveraging Strategic Health Financing for Universal Health (LSF) project, this support has been extended to even HC IIIs in the region.

This preventive and curative maintenance of equipment requires the team at the regional hospital to make regular visits to health centre IVs and IIIs, as they provide training to health workers to be able handle basic equipment. Robin Barugahare, the User trainer based at the Fort Portal Regional Referral Hospital affirms.

This is because most of the equipment faults at HCIVs are due to lack of skills especially on how to operate the machines, use and maintenance. Sometimes they claim a machine is not working and yet it is because they are not maintaining/handling them and sometimes using wrong cable/incompatible cables. Robin Barugahare confirms “we demonstrate basic skills to maintain basic equipment like an oxygen concentrator and how to set an incubator. Sometimes when the vacuum is not connected or the cable not fixed well, it may fail to function.

To confirm the above, the Kyarusozi HC IV, Dr. Ruteganya, the In-Charge says they received 20 oxygen cylinders from NMS, and because they did not know how to operate them, they stayed in the store for 3 months before using them. On top of that they did not know how to fix the stabiliser for a mere lack of a plier to fix it until the team from the regional referral came to demonstrate how to fix it.

Bagaya Shamilah, a nurse at Kyarusozi HC IV also relates that until the regional maintenance team demonstrated to them how to set temperature limits and connect the stabilisers on oxygen concentrators, they used to refer babies to Kyenjojo hospital because they did not know how to operate NICU equipment. Karungi Christine, Enrolled Nurse Kyarusozi HC IV confirms, now we are confidently using the oxygen concentrators and we can fix cylinder with a cylinder head.

Sometimes it is to do with not knowing the correct use but when the maintenance teams show health workers the proper use, health workers confirm improved use. Some health workers openly share that they did not know that some machines use distilled water as confirmed by, Dr, Kayiri Joy Fred In-Charge Rukoki HCIV When we got the autoclave, we did not know it uses distilled water and for us we were using normal water until we were told and now it works well.

Basic training in repairing/operating equipment, proves a multiplier effect to health facilities

When the regional teams travel to carry out preventing repair maintenance, it is now a norm they do on-spot intentional training to health workers. This is proving to have a multiplier effect, first of all there is no delay/denial thus continuity of a service delivery to communities but also the health worker is learning a lifelong skill.

Health workers can now testify that they are able to fix simple basic faults and maintain constant running of facility equipment. Allan Turyahabwe Theatre in charge Kyenjojo General Hospital testifies, there a time we had a challenge with a cylinder head and we did not know how to use it, so we were taught how to use it right. He says he can easily fix it and continue with autoclaving. I am able to regulate the flow of power, I can tell when it’s too much heat and reduce it. At times you can tell when the steam is escaping, there we stop the process and start again.

Mbabazi Doreen, In-charge NICU Bwera hospital I am able to operate an oxygen concentrator, regulate the temperature and in-case it gets a fault, I can easily switch from the concentrator to the cylinder. When the monitor reads no oxygen flow, I can tell and fix it

I can work well with sterilizers/oxygen concentrators. The regional maintenance team found our concentrators dirty and non-functional. They also taught me that I need to replace water for every patient Sr. Akugizibwe Hannah – In Charge Maternity Ward, Bundibugyo General Hospital.

Health workers can now fix/solve minor equipment technical hitches thus able to continue with providing services and reducing fatalities. I can now fix an oxygen concentrator. I can also fix an oxygen cylinder and the cylinder head as well as measure the amount of oxygen to administer, sometimes we receive mothers with foetal distress and I am able to administer oxygen and save that baby’s life reminisces Teddy Kabatooro, Kenjojo Hospital.