Academic literature on the topic 'Health services accessibility. Uganda'

Decentralization of health services in Uganda, driven by the structural adjustment programme of the World Bank, was embraced by government as a means to change the health institutional structure and process delivery of health services in the country. Arising from the decentralization process, the transfer of power concerning functions from the top administrative hierachy in health service provision to lower levels, constitutes a major shift in management, philosophy, infrastructure development, communication as well as other functional roles by actors at various levels of health care. This study focused its investigation on ways and levels to which the process of decentralization of health service delivery has attained efficient and effective provision of health services. The study also examined the extent to which the shift of health service provision has influenced the role of local jurisdictions and communities. Challenges faced by local government leaders in planning and raising funds in response to decentralized health serdelivery were examined.

The research project intends to investigate the issue of health care accessibility with respect to financial obstacles focusing on the case study of Uganda, where impoverishing effects due to health services utilisation are critical for the population well-being. The thesis consists of three independent chapters aimed to examine multiple aspects which are relevant for health coverage and financial protection. In the first chapter, a political economy perspective is adopted to analyse the country experience of health financing reforms for Universal Health Coverage through a desk review and Key Informant Interviews. In the second chapter, household data from a rural district are employed to explore how the provision of social support through social networks operates at the behavioural level for overcoming barriers to health care utilisation and coping with financial hardship due to health expenditures. The analysis presented in the third chapter relies on a longitudinal household survey to assess the impact of a Community Health Financing pilot program on health expenditures and coping strategies. Overall, the thesis can contribute to the current debate on health coverage in Low- and Middle-Income Countries. On one side, the new evidence based on the collection of primary data and the adoption of innovative methodologies allows to advance the academic knowledge on financial protection. On the other side, the main research findings have the potential to inform policy design and policy making to effectively improve health coverage outcomes in informal settings.

The field of radiation oncology (RO) involves the use of highly advanced techniques to treat cancer and safely spare healthy organs. The discipline has experienced rapid growth in the past 25 years, with technological advancement as the driving force. Available data and an instrument to effectively measure the accessibility of innovation in the field were lacking. The purpose of this study was to investigate the accessibility of innovative services in RO in the United States and assess possible diffusion patterns. Two hundred and forty medical physicists practicing in RO in the United States completed a custom Internet-based survey. The diffusion of innovation theory was used as the theoretical framework for the study. A quantitative cross-sectional analysis was performed to assess how innovation scores may vary depending on individual and organizational factors. ANOVA, Spearman correlation, and multiple linear regression were used to analyze the data. University affiliation, urbanicity, appreciation, and motivation were found to be statistically significant factors affecting accessibility to innovative services. Statistically significant barriers preventing innovation were lack of evidence, increased complexity, staffing constraints, lack of interest from others, lack of interoperability, and lack of reimbursement. Medical physicists are in a leadership position to influence the adoption of innovative services in RO. Encouraging the utilization of innovative and Food and Drug Administration-approved techniques may improve cancer outcomes and consequently have a positive social change effect on public health.

Since 2006, Uganda has experienced a nonchanging neonatal mortality rate of 27 out of 1,000 live births, which is higher than the global average of 19 deaths for every 1,000 live births. The purpose of this retrospective cross-sectional study was to determine factors affecting access to health services and their impact on newborn deaths in Uganda. Mosley and Chen's model for child survival in developing nations provided the framework for the study. Secondary data from the 2016 demographic and health survey (UDHS) collected by the Uganda Bureau of Statistics (UBOs) was used. A total of 7,538 cases were used and analyzed using binary logistic regression and one-way analysis of covariance (ANCOVA). The results showed attending less than 4 antenatal care (ANC) visits during pregnancy increased the odds of neonatal deaths 1.57 times, while not taking antimalarial drugs during pregnancy increased the odds of neonatal deaths 1.67 times. However, receiving 4 or more tetanus toxoid (TT) vaccine doses before pregnancy was not statistically associated with an increased risk of neonatal death (p = .597). Also, there was no significant relationship between neonatal mortality and whether distance to health facilities was a challenge (p = .276) or receiving medical assistance during childbirth (p = .420). While there were significant differences in deaths of newborns in geographic regions while controlling for the number of ANC visits (p = .023), there were no differences while controlling for all three covariates, F(4, 117) = 2.00, p = .098. Findings may be used to inform government policies on ANC and malaria prevention during pregnancy, which may reduce neonatal mortality rates in Uganda.

The percentage of deaf and hard of hearing people who need mental health crisis services is similar to the percentage of the general population needing such services. Yet, coordinated mental services for deaf and hard of hearing individuals are virtually nonexistent. People who are deaf and hard of hearing, like everyone else, find themselves, from time to time, in need of mental health services.

The study was an investigation into health care accessibility for children with autism spectrum disorder (ASD) following the transition to a private Medicaid system in the state of Florida. Pilot studies of managed Medicaid programs focused on costs and did not address how changes to the system impacted access to health care services. There were limited studies designed to understand how a change in the system, such as a privatization, would affect vulnerable populations such as young children with ASD. Additional concerns existed for children that were historically underserved by the health care system such as African American and Latino children because they typically had more difficulty accessing health care services in general. A modified version of the Consumer Assessment of Health Providers and System (CAHPS) Survey 4.0 was used in this study. The modifications to the survey included reducing the number of survey questions and adding open-ended questions. 86 participants were recruited from local organizations that supported children and families affected by ASD. Findings generated using nonparametric tests such as the Mann-Whitney U test and chi-square revealed delays in accessing therapeutic health care services that were pervasive in both private and public insurance groups. Furthermore, the qualitative analysis indicated that participants did not view their difficulties in accessing therapeutic health care services as related to race or ethnicity. Limitations of the study included the modifications made to the survey instrument. Implications for positive social change include a better understanding of the scope of the issue of therapeutic health care access for those advocating on behalf of children and families affected by autism.

In a study we conducted with Ontarian women about their abortion experiences (OAS), one third of participants expressed a desire for post-abortion support. Yet, there is some anecdotal evidence to suggest that organizations offering these services are using judgmental frameworks. In order to rigorously investigate this, we explored what post-abortion support services are offered across the province of Ontario. This multi-methods study included an analysis of OAS data, creating a directory of post-abortion support services in the province, conducting an analysis of how these services represent themselves online, and carrying out mystery client interactions. We found that the majority of organizations offering post-abortion support services in Ontario are crisis pregnancy centers. The services offered at these organizations are built upon frameworks that are both shaming and stigmatizing of abortion experiences. Efforts to increase the online visibility and overall accessibility of non-judgmental, medically accurate post-abortion support services in Ontario appear warranted.

Thesis (MPH)--University of Limpopo, 2009.<br>Background Primary Health Care is a basic mechanism that brings healthcare as close as possible to the people. In South Africa, it is seen as a cost effective means of improving the health of the population. It is provided free of charge by the government. This service should be accessible to the population so as to meet the millennium health goals. Aims The aims and objectives of the study were: • To investigate whether Primary Health Care services were accessible to the communities of Tshwane Region. • To determine the utilization of the health care services in the three Community Health Care centres of Tshwane Region. Methodology Data were collected at the three Community Health Care centres of Tshwane Region using self-administered questionnaires. A document review of the Community Health Care centres records was conducted to investigate the utilization trends of services. Descriptive statistics were used. The analysis was based on the information that was elicited from the questionnaires that the people who utilize the Community Health Care centres of Tshwane Region provided. The extracted data emanating from the records from the three centres were also used. Results The study demonstrated that in terms of distance, the Community Health Care centres of Tshwane Region are accessible as most participants lived within 5km. They traveled 30 minutes or less to the clinic. The taxi and walking was the most common form used to access the clinic. The services were utilized with the Tuberculosis clinic being the most visited. Generally, people were satisfied with the service and their health needs are met. Conclusion The Community Health Care centres of Tshwane Region are accessible and utilized effectively. Key words: Primary Health Care, accessibility, utilization.