Access to Health Care by Urban Refugees and Surrounding Host Population in Uganda

Julius Kasozi; Gloria Kirungi Kasozi; Roy William Mayega; Christopher Garimoi Orach

doi:doi:10.11648/j.wjph.20180302.11

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Access to Health Care by Urban Refugees and Surrounding Host Population in Uganda

Julius Kasozi, Gloria Kirungi Kasozi, Roy William Mayega, Christopher Garimoi Orach

Published in World Journal of Public Health (Volume 3, Issue 2)

Received: 12 April 2018 Accepted: 27 April 2018 Published: 19 May 2018

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Abstract

Uganda hosts an estimated 34,200 urban refugees who are living within the peri-urban areas among nationals in Kampala city. The study assessed factors that affect access to health services by the urban refugees and host communities. A cross-sectional study was conducted between July 2011 and June 2012 employing qualitative and quantitative techniques of data collection. Using structured questionnaires and guides, 944 heads of households interviews who were randomly selected using cluster sampling, 6 key informant interviews and 2 focus group discussions were conducted. SPSS, STATA and manifest-content analysis was used for analysis. The factors found to promote access to health services for refugees and host communities were availability of health facilities, (91.2%, 229/246) for refugees compared to (97.8%, 220/224) for nationals (OR = 2.61; 95%CI 1.36-5.03; p<0.05); and geographical accessibility to health facilities within a 5 km distance, (75.6%, 291/384) for refugees compared to (95.5%, 340/356) for nationals (OR=1.64; 95%1.25-2.16; p=0.000). Access was hindered by affordability of health services, refugees (44.9%, 173/385) compared to nationals (80.9%, 288/356) (OR = 4.68; 95%CI 3.33-6.59; p<0.05) and temporal accessibility of health services, refugees (23.5%, 53/226) compared to nationals (67.4%, 203/301) (OR = 2.61; 95%CI 1.36-5.03; p<0.05). Nationals (55.7%, 234/420) compared to refugees (21.3%, 76/356) (OR=0.41; 95%CI 0.23-0.73; p=0.003) perceived health services provided by the public facilities as good. Access to health care by urban refugees is enhanced by availability of and the proximity to health facilities while it is hindered by cost of health care, long-waiting time and low acceptability of the services. Refugees have a poorer perception towards the quality of health services compared to nationals. There is need to invest in the availability of comprehensive health services, demand creation initiatives, refugee skills trainings and income generating activities, establishment of a refugee buddy-system to facilitate communication and institutionalization of a refugee-based village health system.

Published in	World Journal of Public Health (Volume 3, Issue 2)
DOI	10.11648/j.wjph.20180302.11
Page(s)	32-41
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2018. Published by Science Publishing Group

Keywords

Refugees, Urban Refugees, Community Based Health Care, Integrated Health Care, Parallel Health Care, Accessibility

References

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[3]	Spiegel, P, 2010; Conflict-affected displaced persons need to benefit more from HIV and malaria national strategic plans and Global Fund grants as appeared in Conflict and Health 2010, 4:2.
[4]	Ginyera-Pinycwa, A. G. G., 1998;. Uganda and the problem of refugees, Makerere University Press, Kampala Uganda.
[5]	Annual Health report 2010. United Nations High Commissioner for Refugees.
[6]	Inter-Aid, 2010; Socio-Economic Baseline Survey for Urban Refugees in and around Kampala.
[7]	Inter-Aid Uganda, 2010; Urban Refugee Project Annual Reports 2006-2009.
[8]	Kish and Leslie. 1965; Survey Sampling, John Wiley and Sons; New York 1965.
[9]	Kasirye. I.; Lawson. D; Sewanyana. L et al, 2004; Demand for health care services in Uganda: Implications for poverty reduction as appeared in Munich Personal RePec Achieve, MPRA Paper No. 8558.
[10]	Ministry of Haelth, 2010; Health Sector Strategic and Investiment Plan 2010/11-2014/15.
[11]	Penchansky, R.; and Thomas, J. W., 1981; “The concept of access,” Medical Care 19, 127–40, 1981.
[12]	Acuna, D. L.; Gattini, C., Pinto, M., Andersson, B., 2008; Access to and Financing of Health Care: Ways to Measure Inequities and Mechanisms to Reduce Them, Pan American Health Organization (PAHO).
[13]	Nabbuye-Sekandi. J; Makumbi. F; Kasangaki. A et al, 2011; Patient satisfaction with services in outpatient clinics at Mulago hospital, Uganda as appeared in International Journal for Quality in Health Care 2011; pp. 1–8).
[14]	Abdullah, MH, 2005; Study on Outpatients’ Waiting Time in Hospital University Kebangsaan Malaysia (HUKM) Through the Six Sigma Approach.
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[16]	Singh, R 2010; Patients’ Perception towards Government Hospitals in Haryana as appeared in VSRD-TNTJ, 1(4), 2010: 198-206.
[17]	Turkson, P. K, 2009; Perceived quality of health care study in Ghana as appeared in Ghana Medical Journal June 2009, volume 43, Number 2.
[18]	Lawrie, N., Van Damme, W., 2003;. The importance of refugee-host relations: Guinea 1990–2003 as appeared in Lancet. 2003 Aug 16; 362(9383):575.
[19]	World Bank, 2010; The Impacts of Refugees on Neighboring Countries: A Development Challenge as appeared in Word Development Report, 2011
[20]	Orach, G. C.; Brouwere, V., 2005; Integrating refugee and host health services in West Nile districts, Uganda as appeared in Oxford Health and Planning Journal Volume 21 Issue 1 Pg 53-64
[21]	Horn Rebecca, David Bizimana, Scholastica Nasinyama, Lilia Aporo, Emmanuel Kironde, Mark Canavera and Lindsay Stark, 2013; Community based child protection mechanisms among urban refugees in Kampala, Uganda. An ethnographic study. Child Protection in Crisis.
[22]	Francis Anyanzu, 2016. Livelihood and Informality: The case of Urban Refugees and Internally Displaced Persons in Kampala. University of Sessex. http://sro.sussex.ac.uk/
[23]	Merve Ay, Pedro Arcos Gonzalez and Rafael Castro Delgado, 2016. The perceived Barriers of access to health care among a group of non-camp syrian refugees in Jordan. International Journal of Health Services. Vol 46, Issue 3, 2016. http://journals.sagepub.com/doi/abs/10.1177/0020731416636831

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APA Style

Julius Kasozi, Gloria Kirungi Kasozi, Roy William Mayega, Christopher Garimoi Orach. (2018). Access to Health Care by Urban Refugees and Surrounding Host Population in Uganda. World Journal of Public Health, 3(2), 32-41. https://doi.org/10.11648/j.wjph.20180302.11

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ACS Style

Julius Kasozi; Gloria Kirungi Kasozi; Roy William Mayega; Christopher Garimoi Orach. Access to Health Care by Urban Refugees and Surrounding Host Population in Uganda. World J. Public Health 2018, 3(2), 32-41. doi: 10.11648/j.wjph.20180302.11

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AMA Style

Julius Kasozi, Gloria Kirungi Kasozi, Roy William Mayega, Christopher Garimoi Orach. Access to Health Care by Urban Refugees and Surrounding Host Population in Uganda. World J Public Health. 2018;3(2):32-41. doi: 10.11648/j.wjph.20180302.11

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@article{10.11648/j.wjph.20180302.11,
  author = {Julius Kasozi and Gloria Kirungi Kasozi and Roy William Mayega and Christopher Garimoi Orach},
  title = {Access to Health Care by Urban Refugees and Surrounding Host Population in Uganda},
  journal = {World Journal of Public Health},
  volume = {3},
  number = {2},
  pages = {32-41},
  doi = {10.11648/j.wjph.20180302.11},
  url = {https://doi.org/10.11648/j.wjph.20180302.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.wjph.20180302.11},
  abstract = {Uganda hosts an estimated 34,200 urban refugees who are living within the peri-urban areas among nationals in Kampala city. The study assessed factors that affect access to health services by the urban refugees and host communities. A cross-sectional study was conducted between July 2011 and June 2012 employing qualitative and quantitative techniques of data collection. Using structured questionnaires and guides, 944 heads of households interviews who were randomly selected using cluster sampling, 6 key informant interviews and 2 focus group discussions were conducted. SPSS, STATA and manifest-content analysis was used for analysis. The factors found to promote access to health services for refugees and host communities were availability of health facilities, (91.2%, 229/246) for refugees compared to (97.8%, 220/224) for nationals (OR = 2.61; 95%CI 1.36-5.03; p<0.05); and geographical accessibility to health facilities within a 5 km distance, (75.6%, 291/384) for refugees compared to (95.5%, 340/356) for nationals (OR=1.64; 95%1.25-2.16; p=0.000). Access was hindered by affordability of health services, refugees (44.9%, 173/385) compared to nationals (80.9%, 288/356) (OR = 4.68; 95%CI 3.33-6.59; p<0.05) and temporal accessibility of health services, refugees (23.5%, 53/226) compared to nationals (67.4%, 203/301) (OR = 2.61; 95%CI 1.36-5.03; p<0.05). Nationals (55.7%, 234/420) compared to refugees (21.3%, 76/356) (OR=0.41; 95%CI 0.23-0.73; p=0.003) perceived health services provided by the public facilities as good. Access to health care by urban refugees is enhanced by availability of and the proximity to health facilities while it is hindered by cost of health care, long-waiting time and low acceptability of the services. Refugees have a poorer perception towards the quality of health services compared to nationals. There is need to invest in the availability of comprehensive health services, demand creation initiatives, refugee skills trainings and income generating activities, establishment of a refugee buddy-system to facilitate communication and institutionalization of a refugee-based village health system.},
 year = {2018}
}

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TY  - JOUR
T1  - Access to Health Care by Urban Refugees and Surrounding Host Population in Uganda
AU  - Julius Kasozi
AU  - Gloria Kirungi Kasozi
AU  - Roy William Mayega
AU  - Christopher Garimoi Orach
Y1  - 2018/05/19
PY  - 2018
N1  - https://doi.org/10.11648/j.wjph.20180302.11
DO  - 10.11648/j.wjph.20180302.11
T2  - World Journal of Public Health
JF  - World Journal of Public Health
JO  - World Journal of Public Health
SP  - 32
EP  - 41
PB  - Science Publishing Group
SN  - 2637-6059
UR  - https://doi.org/10.11648/j.wjph.20180302.11
AB  - Uganda hosts an estimated 34,200 urban refugees who are living within the peri-urban areas among nationals in Kampala city. The study assessed factors that affect access to health services by the urban refugees and host communities. A cross-sectional study was conducted between July 2011 and June 2012 employing qualitative and quantitative techniques of data collection. Using structured questionnaires and guides, 944 heads of households interviews who were randomly selected using cluster sampling, 6 key informant interviews and 2 focus group discussions were conducted. SPSS, STATA and manifest-content analysis was used for analysis. The factors found to promote access to health services for refugees and host communities were availability of health facilities, (91.2%, 229/246) for refugees compared to (97.8%, 220/224) for nationals (OR = 2.61; 95%CI 1.36-5.03; p<0.05); and geographical accessibility to health facilities within a 5 km distance, (75.6%, 291/384) for refugees compared to (95.5%, 340/356) for nationals (OR=1.64; 95%1.25-2.16; p=0.000). Access was hindered by affordability of health services, refugees (44.9%, 173/385) compared to nationals (80.9%, 288/356) (OR = 4.68; 95%CI 3.33-6.59; p<0.05) and temporal accessibility of health services, refugees (23.5%, 53/226) compared to nationals (67.4%, 203/301) (OR = 2.61; 95%CI 1.36-5.03; p<0.05). Nationals (55.7%, 234/420) compared to refugees (21.3%, 76/356) (OR=0.41; 95%CI 0.23-0.73; p=0.003) perceived health services provided by the public facilities as good. Access to health care by urban refugees is enhanced by availability of and the proximity to health facilities while it is hindered by cost of health care, long-waiting time and low acceptability of the services. Refugees have a poorer perception towards the quality of health services compared to nationals. There is need to invest in the availability of comprehensive health services, demand creation initiatives, refugee skills trainings and income generating activities, establishment of a refugee buddy-system to facilitate communication and institutionalization of a refugee-based village health system.
VL  - 3
IS  - 2
ER  -

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Author Information

Julius Kasozi

Public Health Office, United Nations High Commissioner for Refugees, Kampala, Uganda
Gloria Kirungi Kasozi

World Vision International, Kampala, Uganda
Roy William Mayega

School of Public Health, Makerere University, Kampala, Uganda
Christopher Garimoi Orach

School of Public Health, Makerere University, Kampala, Uganda

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Plain Text BibTeX RIS

APA Style

Julius Kasozi, Gloria Kirungi Kasozi, Roy William Mayega, Christopher Garimoi Orach. (2018). Access to Health Care by Urban Refugees and Surrounding Host Population in Uganda. World Journal of Public Health, 3(2), 32-41. https://doi.org/10.11648/j.wjph.20180302.11

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ACS Style

Julius Kasozi; Gloria Kirungi Kasozi; Roy William Mayega; Christopher Garimoi Orach. Access to Health Care by Urban Refugees and Surrounding Host Population in Uganda. World J. Public Health 2018, 3(2), 32-41. doi: 10.11648/j.wjph.20180302.11

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AMA Style

Julius Kasozi, Gloria Kirungi Kasozi, Roy William Mayega, Christopher Garimoi Orach. Access to Health Care by Urban Refugees and Surrounding Host Population in Uganda. World J Public Health. 2018;3(2):32-41. doi: 10.11648/j.wjph.20180302.11

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@article{10.11648/j.wjph.20180302.11,
  author = {Julius Kasozi and Gloria Kirungi Kasozi and Roy William Mayega and Christopher Garimoi Orach},
  title = {Access to Health Care by Urban Refugees and Surrounding Host Population in Uganda},
  journal = {World Journal of Public Health},
  volume = {3},
  number = {2},
  pages = {32-41},
  doi = {10.11648/j.wjph.20180302.11},
  url = {https://doi.org/10.11648/j.wjph.20180302.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.wjph.20180302.11},
  abstract = {Uganda hosts an estimated 34,200 urban refugees who are living within the peri-urban areas among nationals in Kampala city. The study assessed factors that affect access to health services by the urban refugees and host communities. A cross-sectional study was conducted between July 2011 and June 2012 employing qualitative and quantitative techniques of data collection. Using structured questionnaires and guides, 944 heads of households interviews who were randomly selected using cluster sampling, 6 key informant interviews and 2 focus group discussions were conducted. SPSS, STATA and manifest-content analysis was used for analysis. The factors found to promote access to health services for refugees and host communities were availability of health facilities, (91.2%, 229/246) for refugees compared to (97.8%, 220/224) for nationals (OR = 2.61; 95%CI 1.36-5.03; p<0.05); and geographical accessibility to health facilities within a 5 km distance, (75.6%, 291/384) for refugees compared to (95.5%, 340/356) for nationals (OR=1.64; 95%1.25-2.16; p=0.000). Access was hindered by affordability of health services, refugees (44.9%, 173/385) compared to nationals (80.9%, 288/356) (OR = 4.68; 95%CI 3.33-6.59; p<0.05) and temporal accessibility of health services, refugees (23.5%, 53/226) compared to nationals (67.4%, 203/301) (OR = 2.61; 95%CI 1.36-5.03; p<0.05). Nationals (55.7%, 234/420) compared to refugees (21.3%, 76/356) (OR=0.41; 95%CI 0.23-0.73; p=0.003) perceived health services provided by the public facilities as good. Access to health care by urban refugees is enhanced by availability of and the proximity to health facilities while it is hindered by cost of health care, long-waiting time and low acceptability of the services. Refugees have a poorer perception towards the quality of health services compared to nationals. There is need to invest in the availability of comprehensive health services, demand creation initiatives, refugee skills trainings and income generating activities, establishment of a refugee buddy-system to facilitate communication and institutionalization of a refugee-based village health system.},
 year = {2018}
}

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TY  - JOUR
T1  - Access to Health Care by Urban Refugees and Surrounding Host Population in Uganda
AU  - Julius Kasozi
AU  - Gloria Kirungi Kasozi
AU  - Roy William Mayega
AU  - Christopher Garimoi Orach
Y1  - 2018/05/19
PY  - 2018
N1  - https://doi.org/10.11648/j.wjph.20180302.11
DO  - 10.11648/j.wjph.20180302.11
T2  - World Journal of Public Health
JF  - World Journal of Public Health
JO  - World Journal of Public Health
SP  - 32
EP  - 41
PB  - Science Publishing Group
SN  - 2637-6059
UR  - https://doi.org/10.11648/j.wjph.20180302.11
AB  - Uganda hosts an estimated 34,200 urban refugees who are living within the peri-urban areas among nationals in Kampala city. The study assessed factors that affect access to health services by the urban refugees and host communities. A cross-sectional study was conducted between July 2011 and June 2012 employing qualitative and quantitative techniques of data collection. Using structured questionnaires and guides, 944 heads of households interviews who were randomly selected using cluster sampling, 6 key informant interviews and 2 focus group discussions were conducted. SPSS, STATA and manifest-content analysis was used for analysis. The factors found to promote access to health services for refugees and host communities were availability of health facilities, (91.2%, 229/246) for refugees compared to (97.8%, 220/224) for nationals (OR = 2.61; 95%CI 1.36-5.03; p<0.05); and geographical accessibility to health facilities within a 5 km distance, (75.6%, 291/384) for refugees compared to (95.5%, 340/356) for nationals (OR=1.64; 95%1.25-2.16; p=0.000). Access was hindered by affordability of health services, refugees (44.9%, 173/385) compared to nationals (80.9%, 288/356) (OR = 4.68; 95%CI 3.33-6.59; p<0.05) and temporal accessibility of health services, refugees (23.5%, 53/226) compared to nationals (67.4%, 203/301) (OR = 2.61; 95%CI 1.36-5.03; p<0.05). Nationals (55.7%, 234/420) compared to refugees (21.3%, 76/356) (OR=0.41; 95%CI 0.23-0.73; p=0.003) perceived health services provided by the public facilities as good. Access to health care by urban refugees is enhanced by availability of and the proximity to health facilities while it is hindered by cost of health care, long-waiting time and low acceptability of the services. Refugees have a poorer perception towards the quality of health services compared to nationals. There is need to invest in the availability of comprehensive health services, demand creation initiatives, refugee skills trainings and income generating activities, establishment of a refugee buddy-system to facilitate communication and institutionalization of a refugee-based village health system.
VL  - 3
IS  - 2
ER  -

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