CHAPTER FOUR

PRESENTATION AND ANALYSIS OF DATA

4.0 Introduction

This chapter entails the findings of the study. The findings are presented relating to the purpose of the study which was to factors influencing access to antenatal care services by WWDs in Jinja municipality, Jinja district. A total of 18 respondents participated in the study.

Table 1: Background information of participants

The participants within the age bracket 14-21 dominated in the study than any other age bracket.

4.1 Whether women with disabilities have access to antenatal care services

The study aimed at finding out whether women with disabilities have access to antenatal care services and the responses are reflected below.

Table 2: People who had Knowledge

Table 2 above, (18) respondents knew about antenatal care, 7 respondents understood it as ways taken to space children, (4) respondents looked it as ways used not to have unwanted pregnancies while 7 respondents understand it as the agreement between spouses on the number of children they want to have and stick by that through the use of antenatal care.

When the student asked the respondents about how they acquired the knowledge about antenatal care services they had this to say as seen in table below;

Table 3: Ways in which people acquire knowledge on Antenatal care Services.

Majority of respondents (8) agreed that they acquired knowledge on antenatal care services through workshops, 5 respondents got information from friends or peer groups, 2 said that they got the knowledge through mass media that is radios, televisions, news papers among others. 1 respondent said that Straight talk programmes and 2 agreed that skits and drama was their source of information.

One respondent was quoted saying that; she was not spacing her children and her friend got concerned and told her about antenatal care and in fact she escorted me to my first visit the health center.

4.2 Challenges faced by WWDs while accessing antenatal care services

Distance to the antenatal facility

The responses were very varied as were participants, One challenge that was raised by all the participants was the aspect of distance to the existing antenatal facility in the town council and the available two H/Cs at the parish level which was far away from other four parishes, over 5km as illustrated in the following voice:

‘‘………WWDs face a lot of challenges here because as a town council, we do not have H/Cs in every parish as compared to some town council in the district with H/Cs. And therefore, these WWDs have trouble to go there and come back’’ (key informant)

Lack of enough drugs

Another difficulty which seemed pertinent in the H/C was the inadequacy of drugs in the H/C. Consequently, due to very many people versing a few number of antenatal workers in the antenatal facility made it difficult for most of the WWDs to access antenatal care services as some respondent explained:

‘‘Sometimes one endures the distance to go there and line up but to be disappointed that there are no changes’’ (female WWD)

‘‘you find even WWDs enduring the distance but only to be told to go back home due to many people’’ (male WWDs)

Lack of awareness

Another challenge was lack of awareness for both WWDs and health workers. Some of the participants lamented that they are not well informed about the existing antenatal care services in the H/C because most of the antenatal workers do not have adequate knowledge and skills on the needs:

Both WWDs and key informants indicated that antenatal facilities are ill-prepared to address the antenatal care service needs of WWDs. Most respondents mentioned that antenatal care providers were not trained to handle WWDs, and that some antenatal care providers subject females with disabilities to deliver by cesarean section not knowing they can deliver normally like any other human being, thereby minimizing their ability to deliver normally. This is particularly due to lack of skills to handle pregnant females with disabilities, as the following quotations illustrate:

‘‘If we had information on antenatal care services presented in Braille and large  print, we would have higher chances to information about our condition and the necessary intervention’’ (Female PWVI)

‘‘Having ability to talk really opens every door to access whatever you need. We do not have sign language interpreters that would help us be aware of the available services in H/C III’’ (Male PWHI)

‘‘Service providers are not trained in special skills to handle WWDs. Antenatal care providers get shocked when they receive pregnant WWDs at antenatal facilities. This should not be the case…’’ (Key informant)

‘‘We need to appreciate that delivering WWDs requires particular skills and surely we do not have them at the moment…..’’ (Key informant)

Lack of assistive devices

The absence of assistive devices was one of the challenges that the participants mentioned. These appliances would enhance movement of WWDs to access antenatal care services. The participants said that appliances like crutches and wheel chair would be another limb to help them easily access the antenatal care services from the antenatal facility:

The key informants confirmed that most of the WWDs struggle to forge their ways to the H/C by borrowing any passerby to help them who in most cases ask for money which a WWD does not have:

‘‘We do not have anybody in the our parish a tricycle……even those who received three years ago, when they got spoilt were not repaired. So these people see it as a burden to move to the H/C’’ (Male WWD)

‘‘if wheel chairs or tricycles are given to WWDs, there level of movement and access to antenatal care services would be improved’’

Rudeness of nurses

Another WWD also pointed out the aspect of rudeness of nurses in the H/C and this is usually in relation to their slow response especially to hand in the book, dirty clothes always tantamount WWDs being insulted in the H/C. still another participant pointed out the difficulty to access some rooms in the H/C, especially the narrow doorways which are difficult for one who crawls or uses a wheel chair to pass:

‘‘……….why should I go and end up at the door way. It’s better to just buy drugs………’’ noted another WWD

Lack of enough trained medical personnel

The inadequate medical personnel were also raised by the participants. Most of the participants mentioned that this has resulted into VHTs being recruited to work in the H/C to help the few qualified staff. They said the level of the knowledge needed in the H/C especially for WWDs antenatal needs was not appropriate for the VHTs:

‘‘I find myself work in the H/C because of limited number of nurses and doctors as compared to patients who come to seek antenatal care services….’’ (Remarked one VHT)

‘‘these VHTs even cannot read the names of certain medicines but due to few qualified antenatal workers…..’’ (Key informant)

Shyness of WWDs

In addition, another participant said that most WWDs are shy because of their conditions. Citing an example of those who crawl; even when taken to the H/C, they may not get the necessary help because of low self-esteem.

Both male and female WWDs have low self-esteem to the extent of fearing people like nurses. They always react by seeing their situation as hopeless and therefore refuse to help themselves or to be helped as the quotation illustrates:

‘‘Most of the WWDs are shy most especially those who crawl and it makes it difficult for them to follow lines in the H/C, and also given that there are many people’’

‘‘If I am having multiple disabilities like this, of what benefit do I need to seek for medication? I am only waiting for death. God has already made this condition permanent’’

Indiscrimination

Another participant said that one other challenge WWDs face was the aspect of being treated equally like those who have no any form of disability.

Other ‘normal’ people undermine WWDs and are not sensitive to their needs. They are labeled all sorts of names disabled and dump. On this issue one participant said:

‘‘Even us we line up, there is no consideration or privileges given to us……..in such a case why do I go where I am not catered for basing on my situation’’ (male WWD)

‘‘Sometimes we are not treated like human beings. People look at us as though we desired to be like that, aren’t we human?’’(Female WWD)

4.3 Strategies to improve access to antenatal care services by WWDs

Accordingly participants were asked on what they thought would be the likely remedies to the challenges encountered by WWDs while accessing antenatal care services.

Like the above, responses to this objective were numerous and varied across participants. Although some seemed to cut across all participants, all participants said that antenatal care services ought to be brought nearer the people:

‘‘I need these services nearer because other neighboring places around the town council have antenatal care services. This can favor some of us who are crawling’’ (Male WWD)

Provision of assistive devices

Another participant also requested that wheel chairs should be provided to ease transportation of WWDs seeking antenatal care services from the H/C. Consequently, presence of wheel chairs also enable WWDs with joint problems to spend long time waiting for medication since they can no longer easily get tired as they can sit on their wheel chairs:

The provision of transport means was cited stationed at the H/C. this was cited by one of the WWD’s leader in the town council:

‘‘Both WWDs and antenatal workers need ways of transportation. For the WWDs to reach the H/C and we as antenatal workers to reach out the WWDs patients in case of emergencies’’ (Key informants)

‘‘In case I am given a wheel chair, I will endure to wait in the long line. This is because I can use a wheel chair for sitting’’ (Female WWD)

‘‘If possible, there would be need to get some bicycles at the H/C such that in case a WWD is sick, it’s possible to use by the help of a care giver. This helps to increase access to antenatal care services by WWDs’’ (Key informants)

Immediate attention

Another remedy given by another participant was that WWDs need to be given priority when they reach the H/C. they should be treated as soon as they reach so that they can move back to their places earlier enough. On this still, another participant said that WWDs should be given priority by securing for them their own special room where they receive the antenatal care services:

One participant also suggested that drugs and other items for use in the H/C like mosquito nets should be sent early enough than waiting for them to get over then start requesting for them:

‘‘they should be sympathetic with us because we have no strength to line up……’’

‘‘Medicine should be brought early for us not to go and waste time in the H/C only to be told drugs are over; they should bring them early enough’’ (Female WWD)

Empowerment

Empowerment was one of the remedies to improve WWDs access to antenatal care services. One of the participants said that WWDs should be empowered to help themselves and this would be by bringing them together to form groups that can help them to have a voice and demand for services. And that they can also be trained to start small projects.

Whereas one said that WWDs should be empowered to help themselves than waiting

To be helped as illustrated in the following voice:

‘‘Most of the times ‘normal’ people have high jacked help meant for WWDs here, because they are not empowered and so they have no voice. They should be brought together so that they can be strong….’’ (Key informant)

‘‘………WWDs should do something so that even when help is brought, they can help themselves. They should not sit and expect that government will do everything for them….’’

Awareness raising

In addition, one participant who happened to be a councilor for WWDs said that awareness raising which is well packed needed to be created to help WWDs improve on their knowledge because most of them are not aware of the services available for them in the H/C. He said:

‘‘We still need to create awareness especially in churches so that many people there who come for antenatal care services can facilitate wide spread of information. In churches, there are WWDs, antenatal workers, care givers and also parents of WWDs’’

Networking

Another participant suggested that non- governmental organizations should come up to help WWDs especially by giving WWDs appliances like tricycles wheel chairs, crutches and others. Another said that more nurses and doctors with skills of attending to the WWDs antenatal care needs should be added to the H/C to match the many number of people seeking antenatal care services. In addition, one of the participants said that one person cannot help WWDs and so all stake holders need to come on board to help the people as illustrated in the following quotations:

‘‘WWDs are among the people who are suffering. They cannot even carry water home, even attending social events like weddings, burials is difficult for them and so the family, community, government and WWDs themselves need to come together’’

‘‘……..there are many people in the H/C and for me I think more antenatal workers should be added, all people in the TOWN COUNCIL go to the H/C as other two H/C II units make referrals to the very one H/CIII at the TOWN COUNCIL. I am tired of going there and coming back without any attention because the nurse is also tired………’’

Organization of staff meetings

Another participant pointed out that staff meetings for antenatal workers be organized by management of the H/C so as to sensitize antenatal workers about rights and needs of WWDs seeking antenatal care services. One participant also said that meetings like public antenatal education programs meant for WWDs should be done at the villages within their reach because the distance from the villages to town council alone scares WWDs as expressed by the voice:

‘‘let them help us in our villages than town council H/Q, we do not have transportation means……’’

‘‘If this is done may be they will stop being rude to us…………..’’ (Female WWD)

Implementation of initiated programmes

One of the participants cited out that government agency should effectively and efficiently implement any planned initiative for WWDs. This includes provision of disability friendly antenatal facility equipment like adjustable labor beds, establishment of ramps, sidewalks in the H/C so as to improve on their access to antenatal care services:

‘‘If the modification of the H/C facility is undertaken by various stake holders, I will always bring my wife for ANC and deliver from this H/C…’’ (Male WWD)

Additionally still on this objective, one participant said that the town council authorities should monitor all government programs concerning all people in the town council including WWDs as illustrated by the voice:

‘‘It’s the responsibility of the town council to monitor all programs of government. Even now WWDs are suffering because the town council doesn’t do anything…….’’ (Key informant)