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Coverage of Child Disability Detection, Management, and Rehabilitation Health Services in Central Uganda
Edith Akankwasa1, Willy Kamya1, Moses Sendijja1
1Mildmay Institute of Health Sciences.
Insights
Interventions to improve services for children with disabilities (CwDs) in Uganda showed limited success. Only three of sixteen indicators met the 80% coverage target, highlighting a need for improved community and facility-level support.
Area of Science:
- Public Health
- Disability Studies
- Health Services Research
Background:
- Child disability affects 1 in 20 children, presenting significant public health challenges.
- Children with disabilities (CwDs) face rights deprivation, societal bias, and service access barriers.
- Structural obstacles exacerbate challenges for CwDs, impacting their well-being and access to care.
Purpose of the Study:
- To assess the coverage of child disability prevention, management, and rehabilitation services.
- Evaluate the impact of two years of interventions in four districts of Central Uganda.
- Identify gaps in service delivery for CwDs and their caregivers.
Main Methods:
- Employed Lot Quality Assurance Sampling (LQAS) rapid health facility assessment.
- Assessed sixteen indicators related to service provision, facility readiness, community linkage, and rights protection.
- Set an 80% coverage target for a district-level decision rule.
Main Results:
- Despite interventions, desired service benefits for CwDs and caregivers were not achieved.
- Only three out of sixteen healthcare service coverage indicators for CwDs met the 80% target.
- Significant gaps remain in comprehensive disability service delivery.
Conclusions:
- Enhanced focus is needed from health planners and implementers at community and facility levels.
- Improving prevention, management, and rehabilitation services for CwDs requires further attention.
- Psychosocial support services for caregivers of CwDs require special consideration for better outcomes.
Background:
Child disability is a significant public health concern which impacts 1 in 20 children. Children with disabilities (CwDs) encounter deprivation of rights, biases in society, and a lack of access to necessary services, all of which are exacerbated by structural obstacles. This study assessed the coverage of child disability prevention, management and rehabilitation services in four districts of Central Uganda after two years of interventions to improve these services.
Methods:
The Lot Quality Assurance Sampling (LQAS) rapid health facility assessment method was employed to assess coverage of services based on sixteen indicators. The indicators were set based on constructs of: provision of disability-related services to CwDs; use of rehabilitation services; readiness of the health facilities (HFs) to provide basic disability management and rehabilitation services; community structures for linkage to disability management and rehabilitation services; psychosocial support provision; and upholding and protecting the rights of CwDs. A district-level decision rule was set based on 80% coverage target.
Results:
Despite the interventions, the services have yet to provide the desired level of benefit to CwDs and their caregivers. Out of the sixteen indicators for healthcare service coverage for CwDs, only three attained the 80% coverage target.
Conclusion:
The findings suggest that greater focus by health service planners and project implementers is still needed, especially at the community and health facility levels to enhance the prevention, management and rehabilitation of CwDs. Psychosocial health services for caregivers of CwDs need special attention in order to achieve better service approaches.
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