Kabunga Amir, Udho Samsom, Anyolitho Maxson Kenneth, Musinguzi Marvin, Auma Ann Grace, Nalwoga Viola, Kigongo Eustes
Department of Psychiatry, Lira University, Lira City, Uganda.
Department of Midwifery, Lira University, Lira City, Uganda.
HIV AIDS (Auckl). 2025 May 23;17:77-86. doi: 10.2147/HIV.S521307. eCollection 2025.
HIV-positive pregnant women in refugee settings face significant barriers to accessing quality maternal healthcare. In Uganda, Kiryandongo Settlement Camp, one of the largest refugee settlements, exemplifies these challenges with limited healthcare infrastructure, stigma, and socio-economic constraints affecting healthcare delivery. This study explores the healthcare experiences and service delivery gaps for HIV-positive pregnant women in the camp.
An exploratory qualitative research design was employed in Kiryandongo Settlement Camp, involving purposive sampling of 30 pregnant women living with HIV, 10 healthcare providers, and 5 key informants. Data were collected through in-depth interviews and key informant interviews.
The findings revealed multiple barriers to healthcare access, categorized into three sub-themes: inadequate healthcare infrastructure, long waiting times and staff shortages, and stigma and discrimination. Participants reported frustration with the lack of medical supplies, inadequate facilities, and the impact of stigma on their willingness to seek care. Healthcare providers also acknowledged these challenges, noting limited resources and strained personnel as contributing factors. The most significant finding was the pervasive impact of stigma, which not only hindered service access but also contributed to a reluctance to engage with healthcare services, further affecting ART adherence.
This study highlights the critical need for improvements in healthcare infrastructure, policy interventions to reduce stigma, and increased support for healthcare providers in Kiryandongo Settlement Camp. Addressing these gaps is essential for enhancing ART adherence, maternal health outcomes, and the effectiveness of PMTCT programs in refugee settings. Despite the focus on a single site, the findings have broader implications for refugee health policy and service delivery in similar contexts.
难民环境中的艾滋病毒呈阳性的孕妇在获得优质孕产妇保健方面面临重大障碍。在乌干达最大的难民定居点之一基延东戈定居点营地，有限的医疗基础设施、耻辱感和影响医疗服务提供的社会经济限制体现了这些挑战。本研究探讨了该营地中艾滋病毒呈阳性的孕妇的医疗经历和服务提供差距。
在基延东戈定居点营地采用探索性定性研究设计，对30名感染艾滋病毒的孕妇、10名医疗服务提供者和5名关键信息提供者进行了有目的抽样。通过深入访谈和关键信息提供者访谈收集数据。
研究结果揭示了获得医疗服务的多重障碍，分为三个子主题：医疗基础设施不足、等待时间长和人员短缺，以及耻辱感和歧视。参与者报告了对医疗用品短缺、设施不足以及耻辱感对其寻求医疗服务意愿的影响感到沮丧。医疗服务提供者也承认了这些挑战，指出资源有限和人员紧张是促成因素。最显著的发现是耻辱感的普遍影响，它不仅阻碍了服务获取，还导致不愿参与医疗服务，进一步影响了抗逆转录病毒治疗的依从性。
本研究强调了改善基延东戈定居点营地医疗基础设施、减少耻辱感的政策干预措施以及增加对医疗服务提供者支持的迫切需求。解决这些差距对于提高抗逆转录病毒治疗的依从性、孕产妇健康结果以及难民环境中预防母婴传播项目的有效性至关重要。尽管本研究聚焦于一个地点，但研究结果对类似背景下的难民健康政策和服务提供具有更广泛的意义。
