Abstract
BackgroundUnderstanding individuals’ experience of accessing care and tending to various other needs during chronic illness in a rural context is important for health systems aiming to increase access to healthcare and protect poor populations from unreasonable financial hardship. This study explored the impact on households of access to free healthcare and how they managed to meet needs during chronic illness.MethodsRich data from the life stories of individuals from 22 households in rural south-western Uganda collected in 2009 were analysed.ResultsThe data revealed that individuals and households depend heavily on their social relations in order to meet their needs during illness, including accessing the free healthcare and maintaining vital livelihood activities. The life stories illustrated ways in which households draw upon social relations to achieve the broader social protection necessary to prevent expenses becoming catastrophic, but also demonstrated the uncertainty in relying solely on informal relations.ConclusionImproving access to healthcare in a rural context greatly depends on broader social protection. Thus, the informal social protection that already exists in the form of strong reciprocal social relations must be acknowledged, supported and included in health policy planning.
Highlights
Understanding individuals’ experience of accessing care and tending to various other needs during chronic illness in a rural context is important for health systems aiming to increase access to healthcare and protect poor populations from unreasonable financial hardship
Study setting and sampling This study was nested within the Rural Livelihoods Study (RLS) [19], which was itself based in a larger General Population Cohort (GPC) of the Medical Research Council/Uganda Virus Research Institute Research Unit on AIDS, a cohort of 20,000 people based in Kalungu district [26]
Summary of household characteristics and experience of chronic illness All households that participated in this study were located in an area with access to free healthcare services from the Medical Research Council (MRC) since 1989
Summary
Understanding individuals’ experience of accessing care and tending to various other needs during chronic illness in a rural context is important for health systems aiming to increase access to healthcare and protect poor populations from unreasonable financial hardship. Low-income countries such as Uganda, along with other sub-Saharan African countries, are experiencing an increase in chronic illnesses [1]. Chronic illness can be defined as conditions that require ongoing and longterm healthcare management [2]. As diseases such as human immunodeficiency virus (HIV) become chronic conditions, and with the increasing prevalence of noncommunicable diseases (NCDs), the demand for healthcare resources is increasing. Chronic illness often requires sustained expenditure on healthcare, and due to little financial risk protection in low-income
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