Akankwasa Edith, Kamya Willy, Sendijja Moses, Mudoola Janet, Lwenge Mathias, Onzima Robert Anguyo Ddm, Katongole Simon-Peter
Mildmay Institute of Health Sciences.
Department of International Public Health, Liverpool School of Tropical Medicine.
East Afr Health Res J. 2024;8(2):168-179. doi: 10.24248/eahrj.v8i2.778. Epub 2024 Jun 26.
Child disability is a significant public health concern which impacts 1 in 20 children. Children with disabilities (CwDs) encounter deprivation of rights, biases in society, and a lack of access to necessary services, all of which are exacerbated by structural obstacles. This study assessed the coverage of child disability prevention, management and rehabilitation services in four districts of Central Uganda after two years of interventions to improve these services.
The Lot Quality Assurance Sampling (LQAS) rapid health facility assessment method was employed to assess coverage of services based on sixteen indicators. The indicators were set based on constructs of: provision of disability-related services to CwDs; use of rehabilitation services; readiness of the health facilities (HFs) to provide basic disability management and rehabilitation services; community structures for linkage to disability management and rehabilitation services; psychosocial support provision; and upholding and protecting the rights of CwDs. A district-level decision rule was set based on 80% coverage target.
Despite the interventions, the services have yet to provide the desired level of benefit to CwDs and their caregivers. Out of the sixteen indicators for healthcare service coverage for CwDs, only three attained the 80% coverage target.
The findings suggest that greater focus by health service planners and project implementers is still needed, especially at the community and health facility levels to enhance the prevention, management and rehabilitation of CwDs. Psychosocial health services for caregivers of CwDs need special attention in order to achieve better service approaches.
儿童残疾是一个重大的公共卫生问题,每20名儿童中就有1人受其影响。残疾儿童面临权利剥夺、社会偏见以及无法获得必要服务的问题,而这些问题因结构性障碍而更加严重。本研究评估了在乌干达中部四个地区进行为期两年的改善儿童残疾预防、管理和康复服务干预措施后的服务覆盖情况。
采用批量质量保证抽样(LQAS)快速卫生设施评估方法,根据16项指标评估服务覆盖情况。这些指标是根据以下方面设定的:向残疾儿童提供与残疾相关的服务;康复服务的使用情况;卫生设施提供基本残疾管理和康复服务的准备情况;与残疾管理和康复服务相联系的社区结构;心理社会支持的提供;以及维护和保护残疾儿童的权利。根据80%的覆盖目标设定了地区层面的决策规则。
尽管采取了干预措施,但这些服务尚未为残疾儿童及其照顾者带来预期水平的益处。在残疾儿童医疗服务覆盖的16项指标中,只有3项达到了80%的覆盖目标。
研究结果表明,卫生服务规划者和项目实施者仍需更加关注,尤其是在社区和卫生设施层面,以加强残疾儿童的预防、管理和康复工作。为了实现更好的服务方式,残疾儿童照顾者的心理社会健康服务需要特别关注。