Skip to main content
Top
Published in: International Journal for Equity in Health 1/2014

Open Access 01-12-2014 | Research

Perceptions and experiences of access to public healthcare by people with disabilities and older people in Uganda

Authors: Moses Mulumba, Juliana Nantaba, Claire E Brolan, Ana Lorena Ruano, Katie Brooker, Rachel Hammonds

Published in: International Journal for Equity in Health | Issue 1/2014

Login to get access

Abstract

Introduction

In the year 2000, a set of eight Millennium Development Goals (MDGs) were presented as a way to channel global efforts into the reduction of poverty and the promotion of social development. A global discussion regarding how to renew these goals is underway and it is in this context that the Goals and Governance for Global Health (Go4Health) research consortium conducted consultations with marginalized communities in Asia, Latin America, the Pacific and Africa as a way to include their voices in world’s new development agenda. The goal of this paper is to present the findings of the consultations carried out in Uganda with two groups within low-resource settings: older people and people living with disabilities.

Methods

This qualitative study used focus group discussions and key informant interviews with older people in Uganda’s Kamwenge district, and with persons with disabilities from the Gulu region. Thematic analysis was performed and emerging categories and themes identified and presented in the findings.

Findings

Our findings show that a sense of community marginalization is present within both older persons and persons living with disabilities. These groups report experiencing political sidelining, discrimination and inequitable access to health services. This is seen as the key reason for their poor health. Clinical services were found to be of low quality with little or no access to facilities, trained personnel, and drugs and there are no rehabilitative or mental health services available.

Conclusion

Uganda must fulfil its international obligations and take progressive measures to meet the right to health for all its peoples, but especially allocate its limited resources to proactively support its most marginalized citizens. The growing impetus within post-2015 development negotiations to redress in-country health and other inequalities through a comprehensive systems approach is of importance in the Ugandan development context. This approach reflects the participant’s perspectives, which also calls for a more equitable approach to health and development as opposed to a narrow, vertical focus on specific population groups, as was the case with the MDGs.
Literature
1.
go back to reference International convention of the rights of persons living with disabilities. 2006, United Nations, New York International convention of the rights of persons living with disabilities. 2006, United Nations, New York
2.
go back to reference Sen A: The idea of justice. 2009, Harvard University Press, Boston Sen A: The idea of justice. 2009, Harvard University Press, Boston
4.
go back to reference Moore A: Older people living with HIV/AIDS (OPLWA) i Lome, Togo: personal networks and disclosure of serostatus. Ageing Int. 2013, 38 (3): 218-232. 10.1007/s12126-012-9158-z.CrossRef Moore A: Older people living with HIV/AIDS (OPLWA) i Lome, Togo: personal networks and disclosure of serostatus. Ageing Int. 2013, 38 (3): 218-232. 10.1007/s12126-012-9158-z.CrossRef
5.
go back to reference Shevington S: Is quality of life poorer for older adults with HIV/AIDS? International evidence using the WHOQoL-HIV. AIDS Care Psychological and socio-medical aspects of HIV/AIDS. 2012, 24 (1): 1219-1225. 10.1080/09540121.2012.661838.CrossRef Shevington S: Is quality of life poorer for older adults with HIV/AIDS? International evidence using the WHOQoL-HIV. AIDS Care Psychological and socio-medical aspects of HIV/AIDS. 2012, 24 (1): 1219-1225. 10.1080/09540121.2012.661838.CrossRef
6.
go back to reference Holmes W, Joseph J: Social participation and healthy ageing: a neglected, significant protective factor for chronic, non-communicable conditions. Global Health. 2011, 7: 43-10.1186/1744-8603-7-43.PubMedCentralPubMedCrossRef Holmes W, Joseph J: Social participation and healthy ageing: a neglected, significant protective factor for chronic, non-communicable conditions. Global Health. 2011, 7: 43-10.1186/1744-8603-7-43.PubMedCentralPubMedCrossRef
7.
go back to reference Bank W: Uganda: social inclusion with middle-income status in sight. 2014, World Bank, Washington DC Bank W: Uganda: social inclusion with middle-income status in sight. 2014, World Bank, Washington DC
8.
go back to reference Uganda demographic and health survey 2011. 2012, Uganda Bureau of Statistics, Kampala Uganda demographic and health survey 2011. 2012, Uganda Bureau of Statistics, Kampala
9.
go back to reference 26 December 1966, 993 U.N.T.S. 3, 6, I.L.M. 360 (1967) (entered into force 3 January 1976). 1966 26 December 1966, 993 U.N.T.S. 3, 6, I.L.M. 360 (1967) (entered into force 3 January 1976). 1966
10.
go back to reference A life of dignity for all: accelerating progress towards the Millennium Development Goals and advancing the United Nations development agenda beyond 2015. 2013, United Nations, New York A life of dignity for all: accelerating progress towards the Millennium Development Goals and advancing the United Nations development agenda beyond 2015. 2013, United Nations, New York
11.
go back to reference The millennium development goals report. 2013, United Nations, New York The millennium development goals report. 2013, United Nations, New York
12.
go back to reference A new global partnership: eradicate poverty and transform economis through sustainable development. 2013, United Nations, New York A new global partnership: eradicate poverty and transform economis through sustainable development. 2013, United Nations, New York
13.
go back to reference Kenny C, Glassman A: What will follow the millennium development goals? the high level panel's ambitious recommendations on health deserve support. BMJ. 2013, 347: f4431-10.1136/bmj.f4431.PubMedCrossRef Kenny C, Glassman A: What will follow the millennium development goals? the high level panel's ambitious recommendations on health deserve support. BMJ. 2013, 347: f4431-10.1136/bmj.f4431.PubMedCrossRef
14.
go back to reference Friedman A, Jahn A, Ooms G, Sridhar D, Waris A: Realizing the right to health for everyone: the health goal for humanity. 2013, Go4Health research consortium, Copenhagen Friedman A, Jahn A, Ooms G, Sridhar D, Waris A: Realizing the right to health for everyone: the health goal for humanity. 2013, Go4Health research consortium, Copenhagen
15.
go back to reference Flores W, Ruano AL, Phé-Funchal D: Social participation within a context of political violence: implications for the promotion and exercise of the right to health in Guatemala. Health Human Rights. 2009, 11 (1): 37-48. 10.2307/40285216.PubMedCrossRef Flores W, Ruano AL, Phé-Funchal D: Social participation within a context of political violence: implications for the promotion and exercise of the right to health in Guatemala. Health Human Rights. 2009, 11 (1): 37-48. 10.2307/40285216.PubMedCrossRef
17.
go back to reference Vindevogel S, de Schryver M, Broekaert E, Derluyun I: Challenges faced by former child soldiers in the aftermath of war in Uganda. J Adolesc Health. 2013, 52 (6): 757-764. 10.1016/j.jadohealth.2012.11.014.PubMedCrossRef Vindevogel S, de Schryver M, Broekaert E, Derluyun I: Challenges faced by former child soldiers in the aftermath of war in Uganda. J Adolesc Health. 2013, 52 (6): 757-764. 10.1016/j.jadohealth.2012.11.014.PubMedCrossRef
18.
go back to reference Spitzer H, Twikirize J: War-affected children in northern Uganda: no easy path to normality. Int Soc Work. 2013, 56 (1): 67-69. 10.1177/0020872812459067.CrossRef Spitzer H, Twikirize J: War-affected children in northern Uganda: no easy path to normality. Int Soc Work. 2013, 56 (1): 67-69. 10.1177/0020872812459067.CrossRef
19.
go back to reference Branch A: Gulu in war… and peace? the town as camp in northen Uganda. Urban Stud. 2013, 50 (15): 3153-3167. 10.1177/0042098013487777.CrossRef Branch A: Gulu in war… and peace? the town as camp in northen Uganda. Urban Stud. 2013, 50 (15): 3153-3167. 10.1177/0042098013487777.CrossRef
20.
go back to reference McElroy T, Muyinda H, Atim S, Spittal P, Backman C: War, displacement and productive occupations in northern Uganda. J Occupational Sci. 2012, 19 (3): 198-212. 10.1080/14427591.2011.614681.CrossRef McElroy T, Muyinda H, Atim S, Spittal P, Backman C: War, displacement and productive occupations in northern Uganda. J Occupational Sci. 2012, 19 (3): 198-212. 10.1080/14427591.2011.614681.CrossRef
21.
go back to reference District state of environment report. Uganda: Gulu District Local Government Environmental Department. 2005 District state of environment report. Uganda: Gulu District Local Government Environmental Department. 2005
22.
go back to reference A document of women’s experiences in armed conflict in Uganda-the cae of Gulu district 1986–1999. 2000 A document of women’s experiences in armed conflict in Uganda-the cae of Gulu district 1986–1999. 2000
23.
go back to reference Patel S, Muyinda H, Sewankambo N, Oyat G, Atim S, Spittal P: In the face of war: examining sexual vulnerabilities of Acholi adolescent girls living in displacement camps in conflict-affected northern Uganda. BMC Int Health Human Rights. 2012, 12 (1): 38-10.1186/1472-698X-12-38.CrossRef Patel S, Muyinda H, Sewankambo N, Oyat G, Atim S, Spittal P: In the face of war: examining sexual vulnerabilities of Acholi adolescent girls living in displacement camps in conflict-affected northern Uganda. BMC Int Health Human Rights. 2012, 12 (1): 38-10.1186/1472-698X-12-38.CrossRef
24.
go back to reference Leibling-Kalifani H, Ojiambo-Ochieng R, Marshall A, Were-Ogottu J, Musisi S, Kinyanda E: Violence against women in northen Uganda: the neglected health consequences of war. J Int Women’s Studies. 2008, 9 (3): 174-192. Leibling-Kalifani H, Ojiambo-Ochieng R, Marshall A, Were-Ogottu J, Musisi S, Kinyanda E: Violence against women in northen Uganda: the neglected health consequences of war. J Int Women’s Studies. 2008, 9 (3): 174-192.
25.
go back to reference Loewenson R, Flores W, Shukla A, Kagis M, Baba A, Ryklief A, Mbwili-Muleya C, Kakade D: Raising the profile on participatory action research at the 2010 global symposium on health systems research. MEDICC Rev. 2011, 13 (3): 35-38. 10.1590/S1555-79602011000300008.PubMedCrossRef Loewenson R, Flores W, Shukla A, Kagis M, Baba A, Ryklief A, Mbwili-Muleya C, Kakade D: Raising the profile on participatory action research at the 2010 global symposium on health systems research. MEDICC Rev. 2011, 13 (3): 35-38. 10.1590/S1555-79602011000300008.PubMedCrossRef
26.
go back to reference Robson C: Real world research. 2002, John Wiley and Sons, New York Robson C: Real world research. 2002, John Wiley and Sons, New York
27.
go back to reference Fereday J, Muir-Cochrane E: Demonstrating rigor using thematic analysis: a hybrid approach of inductive and deductive coding and theme development. Int J Qualitative Methods. 2006, 5 (1): 1-11. Fereday J, Muir-Cochrane E: Demonstrating rigor using thematic analysis: a hybrid approach of inductive and deductive coding and theme development. Int J Qualitative Methods. 2006, 5 (1): 1-11.
28.
go back to reference Braun V, Clarke V: Using thematic analysis in psychology. Qual Res Psychol. 2006, 3: 77-101. 10.1191/1478088706qp063oa.CrossRef Braun V, Clarke V: Using thematic analysis in psychology. Qual Res Psychol. 2006, 3: 77-101. 10.1191/1478088706qp063oa.CrossRef
29.
go back to reference Moon B: A life of dignity for all: accelerating progress towards the millennium development goals and advancing the United Nations development agenda beyond 2015. 2013, United Nations, New York Moon B: A life of dignity for all: accelerating progress towards the millennium development goals and advancing the United Nations development agenda beyond 2015. 2013, United Nations, New York
30.
go back to reference Csordas T: Body/meaning/healing. 2002, Palgrave MacMillan, New York Csordas T: Body/meaning/healing. 2002, Palgrave MacMillan, New York
31.
go back to reference Harris C: Gender-age ssytems and social change: a Haugaardian power analysis based on resaerch from northern Uganda. J Political Power. 2012, 5 (3): 475-492. 10.1080/2158379X.2012.735119.CrossRef Harris C: Gender-age ssytems and social change: a Haugaardian power analysis based on resaerch from northern Uganda. J Political Power. 2012, 5 (3): 475-492. 10.1080/2158379X.2012.735119.CrossRef
32.
go back to reference Ruano AL, Hernández A, Dahlblom K, Hurtig AK, SanSebastián M: `It’s the sense of responsibility that keeps you going’: stories and experiences of participation from rural community health workers in Guatemala. Archives Public Health. 2012, 70 (1): 18-10.1186/0778-7367-70-18.CrossRef Ruano AL, Hernández A, Dahlblom K, Hurtig AK, SanSebastián M: `It’s the sense of responsibility that keeps you going’: stories and experiences of participation from rural community health workers in Guatemala. Archives Public Health. 2012, 70 (1): 18-10.1186/0778-7367-70-18.CrossRef
33.
go back to reference World report on disability. 2011, WHO, Malta World report on disability. 2011, WHO, Malta
34.
go back to reference Kritzinger J, Schneider M, Swartz L, Braathen SH: “I just answer `yes’ to everything they say”: Access to health care for deaf people in Worcester, South Africa and the politics of exclusion. Patient Educ Couns. 2014, 94 (3): 379-383. 10.1016/j.pec.2013.12.006.PubMedCrossRef Kritzinger J, Schneider M, Swartz L, Braathen SH: “I just answer `yes’ to everything they say”: Access to health care for deaf people in Worcester, South Africa and the politics of exclusion. Patient Educ Couns. 2014, 94 (3): 379-383. 10.1016/j.pec.2013.12.006.PubMedCrossRef
35.
go back to reference Goicolea I, Coe A, SanSebastián M: Mechanisms for Achieving adolescent services in Ecuador: a realist evaluation approach. Global Health Action. 2012, 2012 (5): ?- Goicolea I, Coe A, SanSebastián M: Mechanisms for Achieving adolescent services in Ecuador: a realist evaluation approach. Global Health Action. 2012, 2012 (5): ?-
36.
go back to reference Flores W: Evaluación del derecho a la salud en Guatemala utilizando a la salud materno-infantil como trazador. 2008, CEDIM, Guatemala Flores W: Evaluación del derecho a la salud en Guatemala utilizando a la salud materno-infantil como trazador. 2008, CEDIM, Guatemala
37.
go back to reference Report of the United Nations Special Rapporteur on the Right to the Highest Attainable Standarf of Physical and Mental Health. 2005, United Nations, New York Report of the United Nations Special Rapporteur on the Right to the Highest Attainable Standarf of Physical and Mental Health. 2005, United Nations, New York
38.
go back to reference Convention on the rights of persons with disabilities, 26 December 1966, 993 U.N.T.S. 3, 6, I.L.M. 360 (1967) (entered into force 3 January 1976). 2006 Convention on the rights of persons with disabilities, 26 December 1966, 993 U.N.T.S. 3, 6, I.L.M. 360 (1967) (entered into force 3 January 1976). 2006
39.
go back to reference Ooms G, Latif L, Brolan C, Hammonds R, Friedman E, Mulumba M, Forman L: Is universal health coverage the practical expression of the right to health care?BMC Int Health Hum Rights 2014, 14(3): doi:10.1186/1472-698X-14-3., Ooms G, Latif L, Brolan C, Hammonds R, Friedman E, Mulumba M, Forman L: Is universal health coverage the practical expression of the right to health care?BMC Int Health Hum Rights 2014, 14(3): doi:10.1186/1472-698X-14-3.,
Metadata
Title
Perceptions and experiences of access to public healthcare by people with disabilities and older people in Uganda
Authors
Moses Mulumba
Juliana Nantaba
Claire E Brolan
Ana Lorena Ruano
Katie Brooker
Rachel Hammonds
Publication date
01-12-2014
Publisher
BioMed Central
Published in
International Journal for Equity in Health / Issue 1/2014
Electronic ISSN: 1475-9276
DOI
https://doi.org/10.1186/s12939-014-0076-4

Other articles of this Issue 1/2014

International Journal for Equity in Health 1/2014 Go to the issue