Barriers and Facilitators to Integration of Social Determinants into Clinical Practice in Hospitals in Uganda

Abstract

Integration of social determinants into clinical practice is an emerging attractive phenomenon because of its potential benefits to the health system and patients however inadequate understanding of the barriers and facilitators poses immense challenges in designing programs and interventions aimed at enhancing integration of social determinants into clinical practice. This study investigated the barriers and facilitators to integration of social determinants into clinical practice in hospitals in Uganda. Data was collected from 21 key informants using a key informant guide that covered various aspects of integration of social determinants into clinical practice. The study identified barriers and facilitators at institutional and health-worker associated barriers. These barriers were at patient, departmental and community levels. There were similarities and differences in the barrier’s ad facilitators observed in this study and those articulated in literature. More so this study revealed some unique barriers and facilitators. The study confirmed existence of barriers and facilitators to integration of social determinants into clinical practice in hospitals in Uganda. Although in-depth interviews were conducted it was not possible to eliminate self-report bias Keywords: Barriers, Facilitators, Social determinants, Integration, Hospitals.