Barriers and potential solutions for improved surgical care for children with hernia in Eastern Uganda

Mary Margaret Ajiko,Jenny Löfgren,Solvig Ekblad

doi:10.1038/s41598-021-90717-2

Mary Margaret Ajiko, Jenny Löfgren + Show 1 more

Open Access

https://doi.org/10.1038/s41598-021-90717-2

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Abstract

Five billion people lack timely, affordable access to surgery. A large proportion of these are children. Qualitative research investigating the barriers to surgical care for children and ways of overcoming them is lacking. This study focused on children with hernia, a very common paediatric surgical condition for which surgery is the only effective treatment. The main aim of this qualitative study was to explore barriers to surgical care for children and identify potential solutions. Data were collected from parents of children with hernia and from health care providers at Soroti Regional Referral Hospital in eastern Uganda. Parents’ experiences, motives and barriers when accessing care were explored. The health care providers’ knowledge, perceptions and practices relating to children with hernia were investigated. The data were analysed using thematic content analysis. Traditional beliefs and gender inequality were considered major issues. Possible solutions included partnering with the local community in efforts to increase knowledge and acceptability in the community in general and by parents in particular. A formation of a surgical team dedicated to the management of children with surgical conditions was suggested as way to improve quality and increase volume of surgery for children.

Highlights

Child health has received particular attention both in the United Nations’ Millennium Development Goals and the subsequent Sustainable Development Goals as part of Agenda 2030
Elective hernia repair is a routine procedure in all health care systems and is relatively simple compared to other paediatric surgical procedures
Twenty-six informants were included in this study: 14 parents with children with hernia (Table 1) and 12 health care providers (Table 2)

Summary

Introduction

Child health has received particular attention both in the United Nations’ Millennium Development Goals and the subsequent Sustainable Development Goals as part of Agenda 2030. Target 3.2 relates to child health and sets out to “end preventable deaths of new-borns and children under 5 years of age.”[2]. The use of empirical findings to build an exploratory and theoretical frame for health-seeking and health-system barriers for children with hernia is important for designing strategies to improve access to and use of care. Elective hernia repair is a routine procedure in all health care systems and is relatively simple compared to other paediatric surgical procedures. For these reasons, hernia was chosen for this qualitative study. Better understanding among parents and health care providers of health care-seeking behaviour and the barriers to supplying adequate surgical care for children with hernia

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Results

Discussion

Conclusion