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

Autor:	Barton SJ; Department of Orthopaedic Surgery, School of Medicine, Duke University, Durham, NC, USA., Sandhu S; Trinity College of Arts and Sciences, Duke University, Durham, NC, USA., Doan I; Trinity College of Arts and Sciences, Duke University, Durham, NC, USA., Blanchard L; Trinity College of Arts and Sciences, Duke University, Durham, NC, USA., Dai A; Trinity College of Arts and Sciences, Duke University, Durham, NC, USA., Paulenich A; Trinity College of Arts and Sciences, Duke University, Durham, NC, USA., Smith ER; Robbins College of Health and Human Sciences, Baylor University, Waco, TX, USA.; Duke Global Health Institute, Duke University, Durham, NC, USA., van de Water BJ; Department of Global Health and Social Medicine, Harvard University School of Medicine, Boston, MA, USA., Martin AH; Global Campaign for Education, Light for the World, Washington, DC, USA., Seider J; Select Physical Therapy, Arlington, VA, USA., Namaganda F; The Mukisa Foundation, Kampala, Uganda.; The Special Children's Trust, Kampala, Uganda., Opolot S; The Neurosurgical Society of Uganda, Kampala, Uganda.; Duke Global Neurosurgery and Neuroscience, Durham, NC, USA., Ekeji N; Trinity College of Arts and Sciences, Duke University, Durham, NC, USA., Bility MM; Trinity College of Arts and Sciences, Duke University, Durham, NC, USA., Bettger JP; Department of Orthopaedic Surgery, School of Medicine, Duke University, Durham, NC, USA.; Duke Global Health Institute, Duke University, Durham, NC, USA.
Jazyk:	angličtina
Zdroj:	Disability and rehabilitation [Disabil Rehabil] 2021 Jul; Vol. 43 (15), pp. 2172-2183. Date of Electronic Publication: 2019 Dec 15.
DOI:	10.1080/09638288.2019.1694999
Abstrakt:	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.
Databáze:	MEDLINE
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