ACCESSIBILITY OF HEALTH SERVICES BY WOMEN WITH DISABILITIES IN BUGEMBE TOWN COUNCIL, JINJA DISTRICT
Introduction
This chapter presents the background of the study, statement of the problem, purpose of the study, objectives of the study, research questions, and scope of the study and significance of the study.
Background to the study
Disability is a decrement in functioning at the body, individual or societal level that arises when an individual with a health condition encounters barriers in the environment (WHO, 2001). Disabled people comprise approximately 10% of the world’s population, 75% of whom live in developing countries, and constitute one of the most poor, marginalised and socially excluded groups in any society (Barron & Amerena. 2007). Disabled people, irrespective of where they live, are statistically more likely to be unemployed, illiterate, to have less formal education, and have less access to developed support networks and social capital than their able-bodied counterparts. Consequently, disability is both a cause and consequence of poverty (Yeo, 2005).
Health is the care one receives from healthcare professionals such as antenatal care, normal treatments. Antenatal care is an important determinant of safe delivery (Bloom et al. 1999). Although certain obstetric emergencies cannot be predicted through antenatal screening, women can be educated to recognise and act on symptoms leading to potentially serious conditions (Bhattia & Cleland 1995); this is one strategy for reducing maternal mortality (Nuraini & Parker 2005). One of the most important functions of ANC is to offer health information and services that can significantly improve the health of women and their infants (WHO & UNICEF 2003). In addition, ANC during pregnancy appears to have a positive impact on the utilization of postnatal healthcare services (Chakraborty et al. 2002).
According to the Uganda Demographic and Health Survey Report, the content of health consumed in Uganda included the measurement of blood pressure, testing of urine for bacteriuria and proteinuria, and blood tests to detect syphilis and severe anaemia. It also includes taking iron supplements, intestinal parasite drugs, tetanus toxoid injections, weight and height measures, and information about danger signs during pregnancy, and where to go in case of complications. However, according to the World Health Organization (WHO) not all items included in health impact on maternal and neonatal health. In a WHO health randomised trial, a new model was introduced with just a few examinations and tests (blood pressure measurement, testing of urine for bacteriuria and proteinuria, and blood tests to detect syphilis and severe anaemia). Routine weight and height measurement at each visit is considered optional.
In particular, women with disability are more likely to be poorer and have lower social and economic status than their counterparts who have no disability. In the context of reproductive health, women with disabilities have largely been ignored in reproductive health research and programming. For example, one recent review on disability in sexual and reproductive health policies and research in Uganda concluded that persons with disabilities have received little attention. Part of the reason for this neglect is that they are often thought not to be sexually active, and less likely to marry or to have children than women without disability (Nyakubega, 2010).
Although Uganda has made progress over the last several decades to improve maternal health, maternal mortality is a serious public health concern. According to the World Health Organization’s (WHO, 2014) most recent estimates, Uganda’s maternal mortality ratio stands at 380 per 100,000 live births. Maternal mortality accounts for 14% of deaths among females aged 12–49 years, and are the second largest cause of female mortality after infectious diseases among women of childbearing age. Despite the fact that Uganda has since implemented a free maternal healthcare policy, more than 45% of births still occur at home without any form of skilled care in parts of Uganda. In addition, large and growing gradients of inequalities in skilled care services accessibility and utilisation have been observed in Uganda.
Uganda has a maternal mortality rate of 325 but most of these deaths have been associated with unsafe abortions and poor reproductive health services especially for the poor mothers and the under aged (Mukisa, 2009). In Uganda, women with disabilities are confronted with life threatening health risks related to unwanted pregnancies, HIV/AIDS and sexually transmitted infections (STIs) which have been addressed by various organizations. However, other reproductive health programs such as family planning have been less successful as indicated by the lower reproductive health indicators in Uganda compared to the region (East Africa) and Sub-Sahara Africa.
In Bugembe town council of the 150 women who come for health and delivery, 16 of them are women with disabilities and Bugembe being a village in Jinja, it contributes to this great problem. It’s upon the above background that that researcher picked interest in carrying out a study about the accessibility of health services by women with disabilities in Bugembe town council, Jinja District.
Purpose of the study
The main purpose of the study is to assess the accessibility of health services by women with disabilities in Bugembe town council, Jinja District.
Specific objectives
To identify health services offered to women with disabilities in Bugembe town council, Jinja District.
To assess the challenges faced by women with disabilities in accessing health services in Bugembe town council, Jinja District.
To suggest strategies to improve health services offered to women with disabilities in Bugembe town council, Jinja District.
Research questions
What health services are offered to women with disabilities in Bugembe town council, Jinja District?
What challenges faced are by women with disabilities in accessing health services in Bugembe town council, Jinja District?
What strategies can be adopted to improve health services offered to women with disabilities in Bugembe town council, Jinja District?
Scope of study
Content Scope
The main purpose of the study is to assess the accessibility of health services by women with disabilities in Bugembe town council, Jinja District. Specifically, the study will identify health services offered to women with disabilities, challenges faced by women with disabilities in accessing health services and suggest strategies to improve health services offered to women with disabilities.
Geographical Scope
The study will be carried out in Bugembe town council, Jinja District. This is due to the easy access to the area and familiarity of the study area.
Time Scope
The study will be carried out for a period of four months in 2017.
Significance of the study
To women with disabilities, the study will help them acquire information on health services by women with disabilities and measures they can employ to improve health services. This will be done by holding a session with them after the research which will take 30 minutes.
To local leaders, the findings will form a basis upon which appropriate interventions can be devised to improve health services. This will be ensured by the researcher giving a report copy to the local leaders.
The research report will act as a source of literature to other future researchers. This will be ensured by putting a copy of the report in the library.
