Department of Social Work and Social Administration, School of Social Sciences, Makerere University, Kampala, Uganda.
Department of Population Studies, School of Statistics and Planning, Makerere University, Kampala, Uganda.
J Glob Health. 2022 Aug 17;12:04065. doi: 10.7189/jogh.12.04065.
The spread of COVID-19 exposed the inadequacies inherent in the health care systems of many countries. COVID-19 and the attendant demands for emergency treatment and management put a significant strain on countries' health care systems, including hitherto strong health systems. In Uganda, as the government strived to contain COVID-19, other essential health care services were either disrupted or completely crowded out. Balancing the provision of COVID-19 treatment and management services and at the same time offering sexual and reproductive health and rights services (SRHR) proved to be a considerable challenge in these circumstances. COVID-19 prevention-related travel restrictions and border closures had far-reaching negative consequences on the mobility of individuals to access essential health services in Uganda. The situation may have been worse for cross-border communities that sometimes access services across the borders.
Using quantitative data from 1521 respondents and qualitative data (20 key informant interviews and 12 focus group discussions), we investigate the disruption in accessing SRHR services for border communities in Uganda during COVID-19.
Results indicate that females (adjusted odds ratio (aOR) = 1.3; 95% confidence interval CI = 1.08-1.79), those with primary education (aOR = 1.47; 95% CI = 1.61-2.57), currently employed (aOR = 2.03; 95% CI = 1.61-2.57) and those with the intention to leave current residence (aOR = 2.09; 95% CI = 1.23-3.55) were more likely to have experienced a disruption in accessing SRHR services. However, respondents aged 35 years, or more were less likely to have experienced a disruption compared to their younger counterparts.
Results shed light on the disruption of access toSRHR services during pandemics such as COVID-19 among a highly mobile population. There is a need to invest in building strong and resilient health care systems that can guarantee continuous access to essential health services including SRHR provisions among mobile populations during pandemics.
COVID-19 的传播暴露了许多国家医疗体系中固有的不足之处。COVID-19 及其伴随的紧急治疗和管理需求，给各国的医疗体系带来了巨大压力，包括迄今为止强大的医疗体系。在乌干达，政府努力控制 COVID-19 的同时，其他基本医疗服务要么中断，要么完全被挤出。在这种情况下，平衡 COVID-19 治疗和管理服务的提供，同时提供性健康和生殖健康及权利服务（SRHR），被证明是一项相当大的挑战。与 COVID-19 预防相关的旅行限制和边境关闭对个人在乌干达获得基本医疗服务的流动性产生了深远的负面影响。对于跨境社区来说，情况可能更糟，因为他们有时需要跨境获取服务。
利用来自 1521 名受访者的定量数据和定性数据（20 名关键知情人访谈和 12 个焦点小组讨论），我们调查了 COVID-19 期间乌干达边境社区获取 SRHR 服务中断的情况。
结果表明，女性（调整后的优势比（aOR）=1.3；95%置信区间（CI）=1.08-1.79）、接受过小学教育的人（aOR=1.47；95%CI=1.61-2.57）、目前有工作的人（aOR=2.03；95%CI=1.61-2.57）和有离开当前居住地意向的人（aOR=2.09；95%CI=1.23-3.55）更有可能经历获取 SRHR 服务的中断。然而，与年轻受访者相比，年龄在 35 岁或以上的受访者经历服务中断的可能性较小。
研究结果揭示了在 COVID-19 等大流行期间，高度流动的人群获取性健康和生殖健康及权利服务的中断情况。有必要投资建设强大和有弹性的医疗体系，以确保在大流行期间，包括流动人群在内的所有人都能持续获得基本医疗服务，包括性健康和生殖健康及权利服务。
