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

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Date
2019-12-15
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
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Abstract
Background: 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.Materials and methods: 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.Results: 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.Conclusions: 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 rehabilitationMultiple, 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.
Type
Journal article
Subject
Rehabilitation
community-based rehabilitation
disability
post-operative care
post-operative recovery
recovery
school-aged children
transitional care
Permalink
https://hdl.handle.net/10161/19720
Published Version (Please cite this version)
10.1080/09638288.2019.1694999
Publication Info
Barton, Sarah Jean; Sandhu, Sahil; Doan, Isabelle; Blanchard, Lillian; Dai, Alex; Paulenich, Alexandra; ... Bettger, Janet Prvu (2019). Perceived barriers and supports to accessing community-based services for Uganda's pediatric post-surgical population. Disability and rehabilitation. pp. 1-12. 10.1080/09638288.2019.1694999. Retrieved from https://hdl.handle.net/10161/19720.
This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.
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Scholars@Duke

Barton

Sarah Jean Barton

Assistant Professor in Orthopaedic Surgery
Assistant Professor of Occupational Therapy and Theological EthicsYou can order my book, Becoming the Baptized Body: Disability and the Practice of Christian Community, from Baylor University Press or your local bookstore!I hold a dual appointment in the School of Medicine and Duke Divinity School. My primary areas of scholarship include Christian
Bettger

Janet Prvu Bettger

Adjunct Associate in the Department of Orthopaedic Surgery
Dr. Bettger’s research is dedicated to establishing real world evidence aimed to improve health care quality and policies that reduce the burden of disease and disability. As a health services researcher and implementation scientist, her research extends from observational studies to randomized and pragmatic trials. She is currently the Director of Duke Roybal Center for Translational Research in the Behavioral and Social Sciences of Aging and Director of Undergraduate Initiatives
Smith

Emily R Smith

Assistant Professor in Emergency Medicine
Emily Smith, PhD, is an Assistant Professor at Duke University with research interests including children’s global surgery, poverty metrics, health economics, and global health policy. As an epidemiologist, she has worked with her in-country partners at the Edna Adan Hospital in Somaliland for the past 5 years on projects related to children’s surgical care, including defining the epidemiologic burden, assessing poverty trajectories among families with a child’s surgical need,
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