Availability of post-hospital services supporting community reintegration for children with identified surgical need in Uganda.
Abstract
BACKGROUND:Community services and supports are essential for children transitioning
home to recover from the hospital after surgery. This study assessed the availability
and geographic capacity of rehabilitation, assistive devices, familial support, and
school reintegration programs for school-aged children in Uganda with identified surgical
need. METHODS:This study assessed the geographic epidemiology and spatial analysis
of resource availability in communities in Uganda. Participants were children with
identified surgical need using the Surgeons OverSeas Assessment of Surgical need (SOSAS).
Community-based resources available to children and adolescents after surgery in Uganda
were identified using publicly available data sources and searching for resources
through consultation with in-country collaborators We sought resources available in
all geographic regions for a variety of services. RESULTS:Of 1082 individuals surveyed
aged 5 to 14 yearsr, 6.2% had identified surgical needs. Pediatric surgical conditions
were most prevalent in the Northern and Central regions of Uganda. Of the 151 community-based
services identified, availability was greatest in the Central region and least in
the Northern region, regardless of type. Assuming 30% of children with surgical needs
will need services, a maximum of 50.1% of these children would have access to the
needed services in the extensive capacity estimates, while only 10.0% would have access
in the minimal capacity estimates. The capacity varied dramatically by region with
the Northern region having much lower capacity in all scenarios as compared to the
Central, Eastern, or Western regions. CONCLUSIONS:Our study found that beyond the
city of Kampala in the Central region, community-based services were severely lacking
for school-aged children in Uganda. Increased pediatric surgical capacity to additional
hospitals in Uganda will need to be met with increased availability and access to
community-based services to support recovery and community re-integration.
Type
Journal articleSubject
HumansSurgical Procedures, Operative
Health Care Surveys
Prevalence
Pediatrics
Adolescent
Child
Child, Preschool
Health Services Needs and Demand
Health Services Accessibility
Uganda
Female
Male
Community Integration
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https://hdl.handle.net/10161/19722Published Version (Please cite this version)
10.1186/s12913-018-3510-2Publication Info
Smith, Emily R; van de Water, Brittney J; Martin, Anna; Barton, Sarah Jean; Seider,
Jasmine; Fitzgibbon, Christopher; ... Bettger, Janet Prvu (2018). Availability of post-hospital services supporting community reintegration for children
with identified surgical need in Uganda. BMC health services research, 18(1). pp. 727. 10.1186/s12913-018-3510-2. Retrieved from https://hdl.handle.net/10161/19722.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
Michael Martin Haglund
Duke Surgery Distinguished Professor of Neurosurgery in the School of Medicine
My clinical areas of expertise include spinal surgery, especially cervical spine surgery
where I have performed almost 8,00 cervical spine procedures and recently was ranked
the top cervical spine surgeon in the country by MPIRICA (an analytical company that
reviews surgical outcomes). I believe the whole patient is important and we emphasize
time with the patient and careful discussions regarding possible surgery. Our excellent
results are due to a great team of physicians, nurses, CRN
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,
Joao Ricardo Nickenig Vissoci
Assistant Professor in Emergency Medicine
Joao Ricardo Nickenig Vissoci, MSc, PhD is an Assistant Professor of Emergency Medicine,
Neurosurgery and Global Health. He is the Chief of the Division of Translational Health
Sciences in the Department of Emergency Medicine, co-Director of the Global Emergency
Medicine Innovation and Implementation (GEMINI) Research Center and a faculty member
of the Research Design and Analysis Core (RDAC) in the Duke Global Health Institute.
Dr. Vissoci has a background in social psychology and data scien
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