Barriers and opportunities for improving management of snakebites: Perspectives of healthcare workers in Northern Uganda

• Published in: PloS one 2023-09, Vol.18 (9), p.e0291032-e0291032
• Main Authors: Wafula, Solomon T, Namakula, Lydia N, Ninsiima, Lesley R, Ssekamatte, Noah Kiwanuka, Walekhwa, Abel W, Mugume, Innocent B, Musoke, David
• Format: Article
• Language: English
• Subjects: Antivenom; Availability; Biological products; Biology and Life Sciences; Bites and stings; Care and treatment; Data collection; Disease management; Drug therapy; Health care; Health care access; Health care reform; Health facilities; Hospital costs; Interviews; Males; Medical diagnosis; Medical personnel; Medicine and Health Sciences; Patient outcomes; Patients; People and Places; Public health; Qualitative research; Reflexivity; Research methodology; Snake bites; Training; Tropical diseases; Workers
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0291032

Background Snakebites are a neglected public health problem that pose a significant burden on affected individuals and communities in many sub-Saharan African countries, including Uganda. However, the barriers and facilitators to snakebite management within healthcare settings are not as well understood and well-documented. The aim of this study was to explore the experiences and perspectives of healthcare workers involved in handling snakebite incidents at individual and health system levels in Arua and Gulu districts in Northern Uganda. We sought to understand how healthcare workers manage snakebite cases, what challenges they encounter, and what opportunities they perceive for improvement. Methods We conducted a qualitative study using in-depth interviews with 18 healthcare workers from different cadres, seniority levels, and facility types. We used iterative thematic analysis to explore the management procedures, challenges, and opportunities for snakebite management. Using thematic analysis, we identified the overarching themes and subthemes related to snakebite management and associated barriers and opportunities. Results The main barriers to snakebite management identified by healthcare workers were inadequate knowledge and skills; limited availability of antivenom; lack of protocols for snakebite management; delayed treatment-seeking for patients; and poor referral systems. The main opportunities for improvement were regular in-service training; increasing public education and awareness about snakebite prevention and management; and increased funding and research. Conclusion This study highlights the need for interventions to address the identified barriers while leveraging the existing opportunities to enhance snakebite management in Uganda. Specifically, we recommend the provision of regular training and support to healthcare workers, developing clinical guidelines, and improving the availability of antivenoms.