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BMC Health Services Research
Published in: BMC Health Services Research 1/2018

Open Access 01-12-2018 | Research article

Availability of post-hospital services supporting community reintegration for children with identified surgical need in Uganda

Authors: Emily R. Smith, Brittney J. van de Water, Anna Martin, Sarah Jean Barton, Jasmine Seider, Christopher Fitzgibbon, Mathama Malakha Bility, Nelia Ekeji, Joao Ricardo Nickenig Vissoci, Michael M. Haglund, Janet Prvu Bettger

Published in: BMC Health Services Research | Issue 1/2018

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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.
Literature
1.
Organization WH. World report on disability. Geneva: Switzerland; 2011.
2.
Cameron DL, Nixon S, Parnes P, Pidsadny M. Children with disabilities in low-income countries. Paediatr Child Health. 2005;10(5):269.CrossRef
3.
Erikson EH. Childhood and society. 2d, rev. and enl. ed. New York U6 - ctx_ver=Z39.88–2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions​.​com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.title=childhood+and+society&rft.au=Erikson%2C+Erik+H.+1902–1994.+%28Erik+Homburger%29&rft.date=1964-01-01&rft.pub=Norton&rft.externalDocID=b12412326&paramdict=en-US U7 - Book: Norton; 1964.
4.
Bronfenbrenner U. Contexts of child rearing: problems and prospects. Am Psychol. 1979;34(10):844–50.CrossRef
5.
Bronfenbrenner U. The ecology of human development: experiments by nature and design. Cambridge: Harvard University Press; 1981.
6.
Abdelgadir JMD, Smith ERP, Punchak MM, Vissoci JRP, Staton CMD, Muhindo AMD, et al. Epidemiology and characteristics of neurosurgical conditions at Mbarara regional referral hospital. World Neurosurg. 2017;102:526–32.CrossRef
7.
8.
Ozgediz D, Poenaru D. The burden of pediatric surgical conditions in low and middle income countries: a call to action. J Pediatr Surg. 2012;47(12):2305–11.CrossRef
9.
Butler EK, Tran TM, Fuller AT, Brammell A, Vissoci JR, de Andrade L, et al. Quantifying the pediatric surgical need in Uganda: results of a nationwide cross-sectional, household survey. Pediatr Surg Int. 2016;32(11):1075–85.CrossRef
10.
Fuller AT, Butler EK, Tran TM, Makumbi F, Luboga S, Muhumza C, et al. Surgeons OverSeas Assessment of Surgical Need (SOSAS) Uganda: Update for Household Survey. World J Surgery. 2015;39(12):2900–7.CrossRef
11.
Saxton AT, Poenaru D, Ozgediz D, Ameh EA, Farmer D, Smith ER, et al. Economic analysis of Children’s surgical Care in low- and Middle-Income Countries: a systematic review and analysis. PLoS One. 2016;11(10):e0165480.CrossRef
12.
Peranich L, Reynolds KB, O'Brien S, Bosch J, Cranfill T. The roles of occupational therapy, physical therapy, and speech/language pathology in primary care. Int J Nurs Pract. 2010;6(1):36–43.CrossRef
13.
Trovato MMD, Kim HMD, Moberg-Wolff EMD, Murphy NMD, Kim CTMDP. Pediatric rehabilitation: 4. Prescribing assistive technology to promote community integration. PM R. 2010;2(3):S26–30.CrossRef
14.
O'Sullivan SB, Schmitz TJ, Fulk GD. Physical rehabilitation. 6th ed. Philadelphia: F.A. Davis; 2014.
15.
Rose JMD, Weiser TGMD, Hider PF, Wilson LF, Gruen RLP, Bickler SWP. Estimated need for surgery worldwide based on prevalence of diseases: a modelling strategy for the WHO Global Health estimate. Lancet Glob Health. 2015;3:S13–20.CrossRef
16.
United Nations Educational SaCO. Toward Inclusive Education for Children with Disabilities: A Guideline. Bangkok: UNESCO Bangkok; 2009.
17.
Penny N, Zulianello R, Dreise M, Steenbeek M. Community-based rehabilitation and orthopaedic surgery for children with motor impairment in an African context. Disabil Rehabil. 2007;29(11–12):839.CrossRef
18.
Kishiki EBA, Shirima SM, Lewallen SMD, Courtright PD. Improving postoperative follow-up of children receiving surgery for congenital or developmental cataracts in Africa. J AAPOS. 2009;13(3):280–2.CrossRef
19.
20.
Bank W. The Uganda poverty assessment report 2016. Washington, DC: The World Bank Group; 2016.
21.
Kagumire R. Public health insurance in Uganda still only a dream. Can Med Assoc J. 2009;180(3):281.CrossRef
22.
23.
Fuller AT, Haglund MM, Lim S, Mukasa J, Muhumuza M, Kiryabwire J, et al. Pediatric neurosurgical outcomes following a neurosurgery health system intervention at Mulago Hospital in Uganda. World Neurosurg. 2016;95:309–14.CrossRef
24.
FHI360. Uganda: National Education Profile (2014). FHI360: Education Policy and Data Center.
25.
Smith ER, Vissoci JRN, Rocha TAH, Tran TM, Fuller AT, Butler EK, et al. Geospatial analysis of unmet pediatric surgical need in Uganda. J Pediatr Surg. 2017;52(10):1691–8.CrossRef
26.
Butler EK, Tran TM, Nagarajan N, Canner J, Fuller AT, Kushner A, et al. Epidemiology of pediatric surgical needs in low-income countries. PLoS One. 2017;12(3):e0170968.CrossRef
27.
Calisti A, Belay K, Mazzoni G, Fiocca G, Retrosi G, Olivieri C. Promoting major pediatric surgical Care in a low-Income Country: a 4-year experience in Eritrea. World J Surg. 2011;35(4):760–6.CrossRef
28.
Toobaie A, Emil S, Ozgediz D, Krishnaswami S, Poenaru D. Pediatric surgical capacity in Africa: current status and future needs. J Pediatr Surg. 2017;52(5):843–8.CrossRef
29.
Ameh E, Bickler S, Lakhoo K, Nwomeh B, Poenaru D. Organization GH, editor. Pediatric Surgery: A Comprehensive Text for Africa. Seattle. WA2011
30.
Abimanyi-Ochom J, Mannan H. Uganda’s disability journey: progress and challenges. Afr J Disabil. 2014;3(1):108.CrossRef
31.
32.
33.
Uganda Society for Disabled Children (no date). Disability Organizations in Uganda: A Directory of National and District Organizations of and for Persons with Disabilities.
34.
Riche N, Anyimuzala J. Research study on children with disabilities living In Uganda. UNICEF; 2014.
35.
36.
Organization WH. Internal classification of functioning - children and youth version. Geneva, Switzerland: World Health Organization; 2007.
37.
38.
Uganda Bureau of Statistics. Uganda demographic and health survey 2011. Kampala: Uganda Bureau of Statistics; 2012.
39.
Uganda Bureau of Statistics. National Population and Housing Census 2014 - Main Report. Kampala: Uganda Bureau of Statistics; 2014. p. 77–86.
40.
Ademuyiwa AO, Usang UE, Oluwadiya KS, Ogunlana DI, Glover-Addy H, Bode CO, et al. Pediatric trauma in sub-Saharan Africa: challenges in overcoming the scourge. J emergencies, trauma, and shock. 2012;5(1):55–61.CrossRef
41.
Adeoye A, Seeley J, Hartley S. Developing a tool for evaluating community-based rehabilitation in Uganda. Disabil Rehabil. 2011;33(13–14):1110.CrossRef
42.
43.
Atijosan O, Simms V, Kuper H, Rischewski D, Lavy C. The orthopaedic needs of children in Rwanda: results from a national survey and orthopaedic service implications. J Pediatr Orthop. 2009;29(8):948–51.CrossRef
44.
Chokotho L, Jacobsen KH, Burgess D, Labib M, Le G, Peter N, et al. A review of existing trauma and musculoskeletal impairment (TMSI) care capacity in east, central, and southern Africa. Injury. 2016;47(9):1990–5.CrossRef
45.
Meara JG, Leather AJ, Hagander L, Alkire BC, Alonso N, Ameh EA, et al. Global surgery 2030: evidence and solutions for achieving health, welfare, and economic development. Lancet. 2015;386(9993):569–624.CrossRef
46.
Poley S, Ricketts T, Belsky D, Gaul K. Pediatric surgeons: subspecialists increasing fastor than generalists. North Carolina: Chapel Hill; 2009.
47.
48.
Mweshi M, Amosun S, Ngoma M, Nkandu E. Managing children with spina bifida in sub-Saharan Africa: the Zambian experience? Med J Zambia. 2011;38(1):13–23.
49.
Organization WH. Review of disability issues and rehabilitation services in 29 Africa countries. Geneva, Switzerland: WHO; 2004.
50.
51.
Holmbeck GN. A developmental perspective on adolescent health and illness: an introduction to the special issues. J Pediatr Psychol. 2002;27(5):409–16.CrossRef
52.
Kaufman M. Role of adolescent development in the transition process. Prog Transplant. 2006;16(4):286–90.CrossRef
Metadata
Title
Availability of post-hospital services supporting community reintegration for children with identified surgical need in Uganda
Authors
Emily R. Smith
Brittney J. van de Water
Anna Martin
Sarah Jean Barton
Jasmine Seider
Christopher Fitzgibbon
Mathama Malakha Bility
Nelia Ekeji
Joao Ricardo Nickenig Vissoci
Michael M. Haglund
Janet Prvu Bettger
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2018
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-018-3510-2

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