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Smith ER, van de Water BJ, Martin A, Barton SJ, Seider J, Fitzgibbon C, Bility MM, Ekeji N, Vissoci JRN, Haglund MM, Bettger JP. Availability of post-hospital services supporting community reintegration for children with identified surgical need in Uganda. BMC Health Serv Res 2018; 18:727. [PMID: 30236098 PMCID: PMC6149201 DOI: 10.1186/s12913-018-3510-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 08/29/2018] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Community services and supports are essential for children transitioning home to recover from the hospital after surgery. This study assessed the availability and geographic capacity of rehabilitation, assistive devices, familial support, and school reintegration programs for school-aged children in Uganda with identified surgical need. METHODS This study assessed the geographic epidemiology and spatial analysis of resource availability in communities in Uganda. Participants were children with identified surgical need using the Surgeons OverSeas Assessment of Surgical need (SOSAS). Community-based resources available to children and adolescents after surgery in Uganda were identified using publicly available data sources and searching for resources through consultation with in-country collaborators We sought resources available in all geographic regions for a variety of services. RESULTS Of 1082 individuals surveyed aged 5 to 14 yearsr, 6.2% had identified surgical needs. Pediatric surgical conditions were most prevalent in the Northern and Central regions of Uganda. Of the 151 community-based services identified, availability was greatest in the Central region and least in the Northern region, regardless of type. Assuming 30% of children with surgical needs will need services, a maximum of 50.1% of these children would have access to the needed services in the extensive capacity estimates, while only 10.0% would have access in the minimal capacity estimates. The capacity varied dramatically by region with the Northern region having much lower capacity in all scenarios as compared to the Central, Eastern, or Western regions. CONCLUSIONS Our study found that beyond the city of Kampala in the Central region, community-based services were severely lacking for school-aged children in Uganda. Increased pediatric surgical capacity to additional hospitals in Uganda will need to be met with increased availability and access to community-based services to support recovery and community re-integration.
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Affiliation(s)
- Emily R. Smith
- Duke Global Health Institute, Duke University, Durham, NC USA
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, One Bear Place #97313, Waco, TX 76798 USA
| | | | - Anna Martin
- Duke University, Sanford School of Public Policy, Durham, NC USA
| | - Sarah Jean Barton
- Physical Therapy and Occupational Therapy, Duke University Medical Center, Durham, NC USA
- Duke University Divinity School, Durham, NC USA
| | - Jasmine Seider
- Department of Orthopedic Surgery, Division of Physical Therapy, Duke University, School of Medicine, Durham, NC USA
| | - Christopher Fitzgibbon
- Mechanical Engineering and Materials Science, Duke University, Durham, NC USA
- Triangle Insights Group, Durham, NC USA
| | | | - Nelia Ekeji
- Duke University, Trinity College, Durham, NC USA
| | - Joao Ricardo Nickenig Vissoci
- Duke Global Health Institute, Duke University, Durham, NC USA
- Department of Surgery, Division of Emergency Medicine, Duke University, School of Medicine, Durham, NC USA
- Division of Global Neurosurgery and Neurology, Duke University, Durham, NC USA
| | - Michael M. Haglund
- Duke Global Health Institute, Duke University, Durham, NC USA
- Division of Global Neurosurgery and Neurology, Duke University, Durham, NC USA
- Department of Neurosurgery, Duke University, Durham, NC USA
| | - Janet Prvu Bettger
- Duke Global Health Institute, Duke University, Durham, NC USA
- Duke University, Sanford School of Public Policy, Durham, NC USA
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