Perceived barriers and supports to accessing community-based services for Uganda's pediatric post-surgical population

Access to pediatric surgical intervention in low-income countries is expanding, but investments in post-surgical care have received less attention. This study explored the barriers and supports for school-aged children to access post-surgical, community-based follow-up care in Uganda as perceived by...

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Bibliographic Details
Published in:	Disability and rehabilitation Vol. 43; no. 15; pp. 2172 - 2183
Main Authors:	Barton, Sarah Jean, Sandhu, Sahil, Doan, Isabelle, Blanchard, Lillian, Dai, Alex, Paulenich, Alexandra, Smith, Emily R., van de Water, Brittney J., Martin, Anna H., Seider, Jasmine, Namaganda, Florence, Opolot, Shem, Ekeji, Nelia, Bility, Mathama Malakha, Bettger, Janet Prvu
Format:	Journal Article
Language:	English
Published:	England Taylor & Francis 17-07-2021
Subjects:	community-based rehabilitation disability post-operative care post-operative recovery recovery Rehabilitation school-aged children transitional care school-aged children community-based rehabilitation disability Rehabilitation recovery post-operative care post-operative recovery transitional care
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Summary:	Access to pediatric surgical intervention in low-income countries is expanding, but investments in post-surgical care have received less attention. This study explored the barriers and supports for school-aged children to access post-surgical, community-based follow-up care in Uganda as perceived by community stakeholders. This qualitative exploratory case study used in-depth, semi-structured interviews and in-country site visits among Ugandan organizations providing follow-up care to school-aged children in Uganda after surgery. Data from eight interviews and eight site visits were coded, analyzed, and cross-tabulated with a modified grounded theory approach. Four key barriers to community-based follow-up care were identified: discrimination, financial barriers, geographical barriers (including transportation), and caregiver limitations to support recovery. Three key supports to successful access to and participation in community-based post-surgical recovery were identified: disability awareness, the provision of sustained follow-up care, and caregiver supports for reintegration. Increasing awareness of disability across local Ugandan communities, educating caregivers with accessible and culturally aware approaches, and funding sustainable follow-up care programming provide promising avenues for pediatric post-surgical recovery and community reintegration in contemporary Uganda. Implications for rehabilitation Multiple, intersecting factors prevent or promote access to post-surgical community-based services among school-aged children in Uganda. The most prominent barriers to pediatric community reintegration in Uganda include discrimination, lack of financial resources, geographical factors, and caregiver limitations. Community and interprofessional alliances must address disability awareness and sources of stigma in local contexts to promote optimal recovery and reintegration after surgery. Collaborative efforts are needed to develop sustainable funding for community-based care programs that specifically support pediatric post-surgical recovery and reintegration. Efforts to provide appropriate and empowering caregiver education are critical, particularly in geographical regions where ongoing access to rehabilitation professionals is minimal.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0963-8288 1464-5165
DOI:	10.1080/09638288.2019.1694999