Mulumba Moses, Nantaba Juliana, Brolan Claire E, Ruano Ana Lorena, Brooker Katie, Hammonds Rachel
Center for Health, Human Rights and Development, Kampala, Uganda.
School of Population Health, The University of Queensland, Brisbane, Australia.
Int J Equity Health. 2014 Oct 8;13:76. doi: 10.1186/s12939-014-0076-4.
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.
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.
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.
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.
2000年，提出了一套八项千年发展目标（MDGs），作为引导全球努力减少贫困和促进社会发展的一种方式。关于如何更新这些目标的全球讨论正在进行，正是在这种背景下，全球健康目标与治理（Go4Health）研究联盟与亚洲、拉丁美洲、太平洋地区和非洲的边缘化社区进行了磋商，以便将他们的声音纳入世界新的发展议程。本文的目的是介绍在乌干达对资源匮乏环境中的两个群体开展磋商的结果：老年人和残疾人。
这项定性研究采用焦点小组讨论和对乌干达卡姆文盖区的老年人以及古卢地区的残疾人进行关键信息访谈。进行了主题分析，并在研究结果中确定并呈现了新出现的类别和主题。
我们的研究结果表明，老年人和残疾人都存在社区边缘化感。这些群体报告称经历了政治边缘化、歧视以及获得医疗服务的机会不平等。这被视为他们健康状况不佳的关键原因。临床服务质量低下，几乎无法获得设施、训练有素的人员和药品，而且没有康复或心理健康服务。
乌干达必须履行其国际义务，并采取渐进措施，以实现其所有人民的健康权，但尤其要分配其有限资源，以积极支持其最边缘化的公民。2015年后发展谈判中通过全面系统方法纠正国内健康和其他不平等现象的日益增长的动力，在乌干达的发展背景下具有重要意义。这种方法反映了参与者的观点，这也要求对健康与发展采取更公平的方法，而不是像千年发展目标那样狭隘地、纵向地关注特定人群。
