02874nas a2200277 4500000000100000008004100001260003700042653002200079653002700101653001100128653001500139100001400154700001600168700001600184700001800200700001600218700001400234700001300248700001200261245012500273856009800398300000900496490000700505520207000512022001402582 2023 d bPublic Library of Science (PLoS)10amultidisciplinary10aHealth care facilities10aUganda10aSnake bite1 aWafula ST1 aNamakula LN1 aNinsiima LR1 aSsekamatte NK1 aWalekhwa AW1 aMugume IB1 aMusoke D1 aOmara T00aBarriers and opportunities for improving management of snakebites: Perspectives of healthcare workers in Northern Uganda uhttps://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0291032&type=printable a1-150 v183 a

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.

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