Work

Unmasking the complexities of healthcare access in low-resource settings: a health systems approach to obstetric and under-5 healthcare in rural settings of Eastern Uganda

Year: 2024

Type: article

Abstract: BACKGROUND: Access to appropriate obstetric and under-5 healthcare services in low-resource settings is a challenge in countries with high mortality rates. However, the interplay of multiple factors within an ecological system affects the effectiveness of the health system in reaching those in need. OBJECTIVE: This study examined how multiple factors concurrently affect access to obstetric and child healthcare services in resource-poor settings. METHODS: = 28] of children aged 6-59 months, and the author's field observations in Eastern Uganda's rural settings. The research employed narrative and inductive thematic analysis, guided by concepts of social interactions, behaviour, and health institutional systems drawn from system theory. RESULTS: The study unmasked multiple concurrent barriers to healthcare access at distinct levels. Within families, the influence of mothers-in-law and gender dynamics constrains women's healthcare-seeking autonomy and agency. At the community level, poor transport system, characterised by long distances and challenging road conditions, consistently impede healthcare access. At the facility level, attitudes, responsiveness, and service delivery of health workers critically affect healthcare access. Negative experiences at health facilities profoundly discourage the community from seeking future health services. CONCLUSION: The findings emphasise the persistent influence of structural and social factors that, although well documented, are often overlooked and continue to limit women's agency and autonomy in healthcare access. Enhancing universal access to appropriate healthcare services requires comprehensive health systems interventions that concurrently address the healthcare access barriers.

Source: Global Health Action

DOI: 10.1080/16549716.2024.2397163

Author: Rornald Muhumuza Kananura

Institutions: African Population and Health Research Center, Makerere University, London School of Economics and Political Science

Language: English

Topic: Global Maternal and Child Health

Subfield: Pediatrics, Perinatology and Child Health

Field: Medicine

Domain: Health Sciences

SDGs: Reduced inequalities, Good health and well-being

Open Access status: gold

Estimated APC paid: $1,509