乌干达中部儿童残疾检测、管理和康复保健服务的覆盖范围。

The East African health research journal Pub Date : 2024-01-01 Epub Date: 2024-06-26 DOI:10.24248/eahrj.v8i2.778
Edith Akankwasa, Willy Kamya, Moses Sendijja, Janet Mudoola, Mathias Lwenge, Robert Anguyo Ddm Onzima, Simon-Peter Katongole
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引用次数: 0

摘要

背景:儿童残疾是一个重大的公共健康问题,每 20 名儿童中就有 1 人受到影响。残疾儿童(CwDs)的权利被剥夺、社会存在偏见、无法获得必要的服务,所有这些都因结构性障碍而加剧。本研究评估了乌干达中部四个地区在采取干预措施两年后儿童残疾预防、管理和康复服务的覆盖情况:方法:采用地段质量保证抽样(LQAS)快速医疗设施评估方法,根据 16 项指标对服务覆盖范围进行评估。这些指标的设定基于以下结构:为残疾儿童提供与残疾相关的服务;使用康复服务;医疗机构(HFs)提供基本残疾管理和康复服务的准备情况;与残疾管理和康复服务挂钩的社区结构;提供社会心理支持;以及维护和保护残疾儿童的权利。根据 80% 的覆盖目标制定了地区一级的决策规则:结果:尽管采取了干预措施,但这些服务尚未为残疾儿童及其照顾者带来预期的益处。在为残疾儿童提供医疗服务的 16 个指标中,只有 3 个指标达到了 80% 的覆盖率目标:研究结果表明,医疗服务规划者和项目实施者仍需加强重视,尤其是在社区和医疗机构层面,以加强对残疾儿童的预防、管理和康复。需要特别关注针对残疾儿童照顾者的社会心理健康服务,以实现更好的服务方法。
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Coverage of Child Disability Detection, Management, and Rehabilitation Health Services in Central Uganda.

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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