Communities and service providers address access to perinatal care in post conflict Northern Uganda: socializing evidence for participatory action
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Date
2021
Journal Title
Journal ISSN
Volume Title
Publisher
Fam Med Com Health
Abstract
Describe participatory codesign of interventions
to improve access to perinatal care services in Northern
Uganda.
Study design Mixed-methods
participatory research to
codesign increased access to perinatal care. Fuzzy cognitive
mapping, focus groups and a household survey identified
and documented the extent of obstructions to access.
Deliberative dialogue focused stakeholder discussions of this
evidence to address the obstacles to access. Most significant
change stories explored the participant experience of this
process.
Setting Three parishes in Nwoya district in the Gulu region,
Northern Uganda.
Participants Purposively sampled groups of women, men,
female youth, male youth, community health workers,
traditional midwives and service providers. Each of seven
stakeholder categories included 5–8 participants in each of
three parishes.
Results Stakeholders identified several obstructions to
accessing perinatal care: lack of savings in preparation for
childbirth in facility costs, lack of male support and poor
service provider attitudes. They suggested joining saving
groups, practising saving money and income generation to
address the short-term
financial shortfall.
They recommended increasing spousal awareness of
perinatal care and they proposed improving service provider
attitudes. Participants described their own improved care-seeking
behaviour and patient–provider relationships as
short-term
gains of the codesign.
Conclusion Participatory service improvement is feasible
and acceptable in postconflict settings like Northern Uganda.
Engaging communities in identifying perinatal service
delivery issues and reflecting on local evidence about these
issues generate workable community-led
solutions and
increases trust between community members and service
providers.
Description
Keywords
Communities and service providers, Perinatal care, Postconflict Northern Uganda
Citation
Belaid L, Atim P, Atim E, et al. Communities and service providers address access to perinatal care in postconflict Northern Uganda: socialising evidence for participatory action. Fam Med Com Health 2021;9:e000610. doi:10.1136/ fmch-2020-000610