Perceived barriers and supports to accessing community-based services for Uganda's pediatric post-surgical population.
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 articleSubject
Rehabilitationcommunity-based rehabilitation
disability
post-operative care
post-operative recovery
recovery
school-aged children
transitional care
Permalink
https://hdl.handle.net/10161/19720Published Version (Please cite this version)
10.1080/09638288.2019.1694999Publication 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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Show full item recordScholars@Duke
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
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
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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