Perceived barriers and supports to accessing community-based services for Uganda's pediatric post-surgical population.
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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.
Published Version (Please cite this version)10.1080/09638288.2019.1694999
Publication InfoBarton, 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.
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Assistant Professor in Orthopaedic Surgery
Assistant Professor of Occupational Therapy and Theological EthicsDepartment of Orthopaedic Surgery, Occupational Therapy Doctorate DivisionDuke Divinity SchoolI hold a dual appointment in the School of Medicine and Duke Divinity School. My primary areas of scholarship include Christian theology and ethics, disability studies, spirituality, and occupational therapy. I focus on participatory research methodologies in partnership with people experiencing in
Associate Professor in 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
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